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Thrombocythemia – Symptoms, Causes, Treatment, Medication

Written by Dr.Mary

Thrombocythemia is an uncommon blood disorder where there is an over-production of platelets with no known reason. Platelets are critical for blood to clot. This condition is referred to as primary thrombocythemia or essential thrombocythemia and is one of a group of disorders of the bone marrow and blood known as myeloproliferative neoplasms.


Normally this disorder affects those individuals in mid stage of life. It can also occur in younger individuals, particularly women under the age of 40.

Individuals with this disorder have too many platelets and can develop a problem with the clotting of blood. Since these platelets do not work correctly, bleeding is also a common problem.

An individual with this disorder may not need any treatment if the individual is not experiencing any symptoms. But if there is any abnormal bleeding or blood clotting, medications can help to evade possibly serious difficulties.

Thrombocythemia Symptoms

Most individuals with this condition will have no symptoms or signs. Usually the first sign that an individual has the disorder can be when there is the progression of blood clots. These clots can develop in any area in the body but they occur most frequently in the brain, feet and hands.

Symptoms and signs of this disorder include:

  • Bleeding from the gums
  • Bleeding from gastrointestinal tract
  • Bloody stools
  • Easy bruising
  • Dizziness
  • Rarely enlarged lymph nodes
  • Nosebleeds
  • Headache
  • Numbness of feet or hands
  • Prolonged bleeding after surgical procedures or extraction of teeth
  • Ulcers on toes or fingers

Symptoms which are less common with this disorder can create bleeding, particularly if the count of platelets is very high –greater than 1 million platelets/microliter of blood. Bleeding can consist of:

  • Bleeding from gums or mouth
  • Nose-bleeds
  • Bruising
  • Bloody stool

Any blood clot can cause TIA or “transient ischemic attack” – which is the momentary disruption of blood flowing to a part of the brain – or stroke. Symptoms and signs normally develop abruptly and consist of:

  • Numbness or weakness of arm, leg or face, customarily on only one side of the body
  • Difficulty with speech or speech understanding – aphasia
  • Decreased, blurred or double vision

An individual should be checked by a health care professional if:

  • There are unexplained or prolonged episodes of bleeding
  • Chest pains, confusion, leg pain, weakness, numbness or any other new symptoms develop

Thrombocythemia Causes

Bone marrow which is tissue that is spongy located inside the bones encloses stem cells that develop into red cells, platelets, or white cells. Platelets flow thru the blood system. They stick to each other to develop clots anywhere they are needed in order to halt bleeding when there is a damaged blood vessel, for example when an individual sustains a cut. The standard platelet count varies from approximately 150,000 to near 450,000 platelets/microliter of blood.

But with thrombocythemia, the marrow of the bone makes too numerous platelets in the blood. These excess platelets often cannot function ordinarily, leading instead to bleeding or clotting which is abnormal.

The exact reason of this abnormality is not known. Approximately half of individuals with this ailment have a JAK2 gene mutation. Other mutations of genes can be linked with this disorder. The reason that these mutations play a role in causing this disorder is being researched and investigated.

A type of thrombocythemia which is very rare is also genetic.

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A platelet count which is very high that is caused by a primary disorder for instance an infection or deficiency of iron is referred to as secondary or reactive thrombocytosis.

The abnormal clotting of the blood in this condition often leads to a diversity of serious complications together with:

Pregnancy Complications

When this disorder is not controlled it can cause high blood pressure or preeclampsia, early delivery, early parting of the placenta from the uterine wall or placental abruption as well as slow growth of the fetus. It also can cause miscarriages. The pregnant woman should be carefully monitored thru out the pregnancy.

Stroke

Any clot that blocks blood flowing to the brain can create a stroke. If in individual notices any symptoms or signs of a stroke, get medical attention immediately.

Heart attack

Any clot that blocks blood flowing to the heart can cause a heart attack. If signs of a heart attack occur such as fullness, pressure or squeezing type pain in the middle of the chest which last longer than a couple of moments, pain spreading to the shoulder, back, arm, jaw or teeth, shortness of breath and sweating, get medical attention immediately.

Thrombocythemia Treatment

The treatment of thrombocythemia depends on the risk of episodes of bleeding or blood-clotting. If the individual is younger than 60, with no symptoms or signs and have no further risk factors for developing clots such as smoking, periodic checkups is all that is needed. If the individual is older than 60 and has had any previous signs or symptoms of blood clots, the physician will more than likely prescribe medication or a medical procedure to lower the level of platelets. It also may be recommended treatment if the individual has any risk factors for cardiovascular problems for instance high blood pressure, high cholesterol or diabetes.

Thrombocythemia Medication

If the individual is at risk of blood clots, the physician may recommend low-dose aspirin, especially if that patient is pregnant. Aspirin causes the platelets to be less sticky and therefore less likely to form clots.

Drugs that can reduce the platelet count and commonly used to treat thrombocythemia include:

Hydroxyurea

This drug suppresses bone marrow creation of blood cells including platelets. It is used to treat cancers and it is the most commonly prescribed platelet lowering medication. Long term use has a risk of developing leukemia

Anagrelide

There is no risk associated with this medication of developing leukemia. But it is not as effective as hydroxyurea. Side effects consist of heart problems, dizziness, nausea and diarrhea as well as fluid retention.

Interferon alfa-2B

This is given by injection and is less convenient to use as the above 2 medications. It is very expensive and has less tolerable side effects. They are flu-like symptoms, confusion, depression, nausea, diarrhea, irritability, seizures as well as sleepiness

Plateletpheresis

This is used only in emergencies for instance stroke or other blood clotting problems. This process is used to lower platelet count rapidly. With this procedure, an IV needle is connected to a tube inserted into one of the patient’s blood vessels. Blood flows thru the tube and into a device that removes platelets from the blood. Remaining portion of the blood and red cells are then return to the patient thru an IV line. Effects are only temporary.

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