Differential diagnosis of thrombocytosis

 

MYELOPROLIFERATIVE DISORDERS

Essential thrombocythemia

Polycythemia vera

Chronic myelogenous leukemia

Myelofibrosis

 

SECONDARY THROMBOCYTOSIS

Recovery from acute infection

Malignant disease

 

Carcinoma

 

 

Hodgkin's disease

 

 

Lymphoma

 

Hemolytic anemia

Postoperative

 

Splenectomy

 

 

Other surgical procedures

 

Acute hemorrhage

Iron deficiency

Response to drugs

 

Epinephrine

 

 

Vincristine

 

Chronic inflammatory disorders

 

Rheumatoid arthritis

 

 

Ulcerative colitis

 

 

Hepatic cirrhosis

 

 

Sarcoidosis

 

Response to exercise, stress

Recovery from myelosuppresive drugs

Therapy of vitamin B12 deficiency

Others: Osteoporosis, 5q - syndrome

 

DISORDER
RBC
WBC
PLTS
Bone Marrow
Fibrosis
Splenomegaly
Leukocyte Alkaline
Phosphatase
Ph
Risk of
Thrombosis/Bleeding
Leukemoid Reaction
-
++
-
-
-
Increased
-
-
Reactive Thrombocytosis
-
-
++
-
-
Normal
-
-
Chronic Myelogenous Leukemia
-
+++
+++
+(Late event)
+++
Decreased
+
+/-
Polycythemia Vera
+++
++
++
+/-
+/-
Increased
_
+
Essential Thrombocythemia
-
+/-
+++
+/-
+/-
Normal/Increased
-
+
Myeloid Metaplasia
-
++
++
+++
+++
Normal/Inc/Dec
-
+

Ph = Philadelphia chromosome