Thrombocytosis: The Daily PANCE Blueprint

Home Thrombocytosis: The Daily PANCE Blueprint

Thrombocytosis: The Daily PANCE Blueprint

A 68-year-old male with a history of hypertension presents to the ER complaining of a cough and chills. Vitals reveal hypoxemia (SpO2 86%) and a fever (39C). Labs reveal leukocytosis (WBC 23K/uL), thrombocytosis (480,000 platelets/mcL), and elevated procalcitonin (15.32ng/mL). Chest radiograph demonstrates a new opacity in the right middle lobe. Which of the following best explains the cause of the thrombocytosis?

A. Likely an underlying myelodysplastic syndrome
B. From an undiagnosed rheumatic disease
C. Due to an acute hemolytic anemia
D. It's a reactive process to the infection
E. None of the above

Answer and topic summary

The answer is D. It’s a reactive process to the infection

Thrombocytosis refers to increased platelet count (>450,000 platelets/microL). Thrombocytosis can be caused by either reactive (more common) or autonomous processes. Some causes of reactive thrombocytosis include blood loss, hemolysis, infections, rheumatic disease, and cancer. Typically in these cases, the thrombocytosis is driven by the overproduction of thrombopoietin, cytokines (like IL-6), or catecholamines in various inflammatory, infectious, or neoplastic conditions. Causes of autonomous thrombocytosis include hematologic malignancies (like polycythemia vera, myelodysplastic syndromes, acute or chronic myeloid leukemia) and familial thrombocytosis. All patients should have CBC and differential count, review of a blood smear, and a good history/physical exam.

View blueprint lesson

Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Hematology ⇒ Cytoses ⇒ Thrombocytosis

Also covered as part of the Emergency Medicine EOR topic lists