Trombocytopenietrombocytose

Trombocytopenietrombocytose refers to disorders of platelets in which the platelet count is either abnormally low (thrombocytopenia) or abnormally high (thrombocytosis). Platelets play a key role in hemostasis, and disorders of their number or function can lead to bleeding or clotting complications. Both conditions require evaluation of the underlying cause and, when needed, targeted treatment.

Thrombocytopenia is defined by a platelet count typically below 150,000 per microliter. Causes are grouped into reduced production (for example, bone marrow failure, leukemia, chemotherapy), increased destruction (immune thrombocytopenia, certain infections), sequestration (splenomegaly), or dilutional effects after massive transfusion. Symptoms range from none to significant bleeding, easy bruising, petechiae, and mucosal bleeding. Diagnosis involves a complete blood count with smear review, reticulocyte count, iron studies, and tests for underlying illnesses. Bone marrow examination may be indicated if the cause is unclear. Management targets the underlying cause; severe bleeding may require platelet transfusions, and specific therapies such as immune-modulating treatments for ITP or treatable infections.

Thrombocytosis refers to a high platelet count, usually above 450,000 per microliter. It can be reactive (secondary) to infection, inflammation, iron deficiency, recent surgery or trauma, splenectomy, or rebound after platelet consumption. It can also be clonal (primary), most commonly essential thrombocythemia, a myeloproliferative neoplasm often associated with mutations such as JAK2, CALR, or MPL. Reactive thrombocytosis typically resolves with treatment of the underlying condition and generally carries a lower thrombotic risk. Essential thrombocythemia carries a higher risk of arterial or venous thrombosis and sometimes bleeding; management may include low-dose aspirin and cytoreductive therapy (for example, hydroxyurea, with alternatives like anagrelide or interferon) and regular monitoring of blood counts and risk factors.

Both conditions require careful assessment to distinguish reactive from primary causes and to guide appropriate therapy.