Recognizing thrombocytosis, when the platelet level is too high

Platelets or platelets, or you may also know them as platelets, are blood components that play an important role in the process of stopping bleeding. However, a platelet level that is too high in the body can actually cause certain health problems. This condition is known as thrombocytosis. What causes the soaring platelet count? What is the danger if the platelets rise drastically? Check out the explanation in this article.

What is thrombocytosis?

Platelets are pieces of blood that are produced in the bone marrow by cells called megakaryocytes. Platelets have an important role in the hemostasis process, aka the blood clotting process.

Normal platelet levels in the blood are between 150,000-450,0000 pieces per microliter (mcL) of blood. If the amount is too little or too much, you may have a platelet disorder.

Thrombocytosis is a condition where the platelets increase in excess of 450,000 pieces per microliter. Thrombocytosis, also known as thrombocythemia, occurs when the cells in the bone marrow produce too many platelets. As a result, the blood clotting process cannot run normally.

In general, thrombocytosis is divided into 2 based on the cause, namely:

• Primary or essential thrombocythemia, if the cause of increased platelets is not known with certainty
• Secondary thrombocytosis, if the increase in platelets is caused by certain diseases or health conditions

What are the signs and symptoms of thrombocytosis?

In most people, thrombocytosis does not cause certain signs and symptoms. Therefore, most cases of this disease are only discovered when a person has a blood test at the time of examination at a doctor or hospital for other health purposes.

However, according to the National Heart, Lung, and Blood Institute website, people with essential thrombocythemia are more likely to have serious symptoms than secondary thrombocytosis.

Signs and symptoms of high platelets are usually related to symptoms of abnormal blood clots and bleeding. Here's the explanation.

1. Blood clots (blood clot)

Excess platelets in the blood vessels can cause abnormal blood clots, which is known as thrombosis. Blood clots can appear in any part of the body, such as the arms, legs, heart, intestines, and brain.

If the blood clots are in your arms and legs, you may experience a sensation of numbness or numbness and a reddish color. Sometimes, these symptoms can also be accompanied by burning or sharp pain in the hands and feet.

If thrombosis has reached the brain, signs and symptoms may include dizziness and prolonged headaches. In more severe cases, sufferers can have a stroke.

The following are other signs and symptoms of thrombosis or blood clots due to thrombocytosis:

• Impaired eyesight
• Seizures
• Decreased consciousness
• Speaking less fluently
• Fainting
• Discomfort in the arms, back, neck, jaw, or stomach
• Hard to breathe

2. Bleeding

Symptoms of bleeding usually occur when a person with thrombocytosis has more than 1 million platelets per microliter of blood. Yes, although bleeding is more often associated with people whose platelets are very low (thrombocytopenia), it turns out that people with thrombocytosis can also develop abnormal bleeding problems.

Bleeding disorders are characterized by symptoms such as:

• Easy bruising or bruising (hematoma)
• Bleeding on the gums
• Urinate or defecate accompanied by blood
• Nosebleed

From the symptoms, physical examination, and laboratory tests performed, thrombocytosis needs to be aware of if:

• Continuous increase in platelets (above 450,000 / mcL)
• Bone marrow biopsy found an increase in the number of megakaryocytes (hyperplasia).
• Mild spleen enlargement (splenomegaly)
• There are complications of thrombosis, bleeding, or both

If there are symptoms of a mild stroke such as numbness or paralysis of half body heart attack symptoms such as chest pain in the left radiating to the arms, shoulders, jaw, accompanied by tightness and sweating; or symptoms of bleeding and abnormal blood clots, see a doctor immediately.

What causes high platelets (thrombocytosis)?

As previously mentioned, the causes of thrombocytosis can be divided into 2, namely essential thrombocythemia and secondary thrombocytosis.

Essential or primary causes of thrombocythemia

In this condition, platelet levels jump high due to abnormalities in the stem cells in the bone marrow, where platelets are produced. However, the exact cause of essential thrombocythemia is unknown.

However, based on information from the Leukemia and Lymphoma Society, about half of essential thrombocythemia patients have a mutated gene in their body, namely the JAK2 gene (Janus kinase 2). Experts are still trying to find out what the relationship between the JAK2 gene mutation and the production of platelets in the body.

Due to gene mutation, essential thrombocythemia is thought to occur due to heredity. In other words, the mutated gene could be inherited from the sufferer's parents.

Causes of secondary thrombocytosis

This condition occurs when there are health problems or other diseases that trigger high platelets. About 35% of thrombocytosis patients usually have lung cancer, digestive system, breast, uterus, and lymphoma. High platelet levels are sometimes recognized as an early symptom of cancer. However, that does not mean you will definitely get cancer if you have high platelets.

Apart from cancer, several other diseases and problems that cause high platelets, include:

• Tissue inflammation, such as in vascular and collagen disease inflammatory bowel disease
• Infection and inflammatory diseases, such as tuberculosis (TB)
• Myeloproliferative disorders (disorders of the bone marrow) such as polycythemia vera
• Myelodysplastic disorders
• Hypersplenism, usually occurs after a procedure to remove the spleen
• Hemolytic anemia
• Iron deficiency anemia
• Operation
• The body's response after treatment for vitamin B12 deficiency or after alcohol abuse
• Recovery after the body has lost too much blood

In essential thrombocythemia, platelet performance also tends to be abnormal. As a result, it is easier for blood clots to form or you may experience abnormal bleeding.

Meanwhile, the platelets in people with secondary thrombocytosis can still work properly, regardless of the excess number. That's why people with a secondary excess of platelets are less likely to develop serious symptoms.

What complications might arise if the platelets are too high?

Platelet levels that are too high are prone to make you experience blood clots. That is why, this condition must be treated immediately.

Thrombocytosis that is not treated promptly can lead to health complications, such as:

• Stroke
• Heart attack
• Pregnancy complications, such as miscarriage, abnormal growth of the fetus, premature birth, and separation of the placenta from the uterine wall.

Can thrombocytosis be treated?

Currently there is no specific treatment for thrombocytosis. However, some possible treatments based on a number of studies are:

• In cases that do not have risk factors for the heart and blood vessels, only further examination and control is carried out.
• If von Willerbrand's disease is present, bleeding can be prevented by administering e-aminocaproic acid.
• Plateletpheresis or thromboferesis (the process of removing platelets).
• For the prevention of minor strokes, hydroxyurea and aspirin class drugs can be given. However, giving aspirin must consider the risk of bleeding, especially gastrointestinal bleeding

A healthy lifestyle can also help overcome the complications of secondary thrombocytosis and essential thrombocythemia. By adopting a healthy lifestyle, the risk factors for blood clots such as diabetes, high blood pressure and high cholesterol will be reduced. This can be done by following a balanced diet, increasing physical activity, maintaining an ideal body weight, and quitting smoking.