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    Essential Thrombocytosis

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    Gd Padmawijaya
    This document discusses essential thrombocythemia (ET), a clonal myeloproliferative disorder characterized by overproduction of platelets in the bone marrow without an identifiable cause. ET can occur at any age and predominantly affects women. Patients may experience hemorrhagic or thrombotic symptoms. Physical exams are typically normal except for possible mild splenomegaly. Treatment involves medications like hydroxyurea, anagrelide, or aspirin to control platelet counts and reduce thrombotic risks. Complications include thrombosis, hemorrhage, and neurological problems. Prognosis for ET is generally indolent with long-term survival, though transformation to myelofibrosis or leukemia can occasionally occur.

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    Essential Thrombocytosis

    Uploaded by

    Gd Padmawijaya
    68 views12 pages
    This document discusses essential thrombocythemia (ET), a clonal myeloproliferative disorder characterized by overproduction of platelets in the bone marrow without an identifiable cause. ET can occur at any age and predominantly affects women. Patients may experience hemorrhagic or thrombotic symptoms. Physical exams are typically normal except for possible mild splenomegaly. Treatment involves medications like hydroxyurea, anagrelide, or aspirin to control platelet counts and reduce thrombotic risks. Complications include thrombosis, hemorrhage, and neurological problems. Prognosis for ET is generally indolent with long-term survival, though transformation to myelofibrosis or leukemia can occasionally occur.

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    FK UNISMUH 2013

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    This document discusses essential thrombocythemia (ET), a clonal myeloproliferative disorder characterized by overproduction of platelets in the bone marrow without an identifiable cause. ET can occur at any age and predominantly affects women. Patients may experience hemorrhagic or thrombotic symptoms. Physical exams are typically normal except for possible mild splenomegaly. Treatment involves medications like hydroxyurea, anagrelide, or aspirin to control platelet counts and reduce thrombotic risks. Complications include thrombosis, hemorrhage, and neurological problems. Prognosis for ET is generally indolent with long-term survival, though transformation to myelofibrosis or leukemia can occasionally occur.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    68 views12 pages

    Essential Thrombocytosis

    Uploaded by

    Gd Padmawijaya
    This document discusses essential thrombocythemia (ET), a clonal myeloproliferative disorder characterized by overproduction of platelets in the bone marrow without an identifiable cause. ET can occur at any age and predominantly affects women. Patients may experience hemorrhagic or thrombotic symptoms. Physical exams are typically normal except for possible mild splenomegaly. Treatment involves medications like hydroxyurea, anagrelide, or aspirin to control platelet counts and reduce thrombotic risks. Complications include thrombosis, hemorrhage, and neurological problems. Prognosis for ET is generally indolent with long-term survival, though transformation to myelofibrosis or leukemia can occasionally occur.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 12

    Essential Thrombocytemia

    Dimas Bayu
    Tutik Harjianti
    A. Fachruddin
    Division of Hematology & Oncology - Dept. of Internal Medicine
    Faculty of Medicine, Hasanuddin University

    Essential thrombocytosis:
    vIs a clonal disorder of unknown etiology.
    vOver production of platelets in the absence of
    definable reason.
    vIt can occur at any age group.
    vUnexplained female predominance.

    Essential Thrombocytemia (ET)

    Myeloproliferative disorders
    Essential
    Thrombocytemia

    Idiopathic
    megakaryocyte proliferation in bone
    marrow >> thrombocyte >>

    Division of Hematology & Oncology Dept. of Internal Medicine

    Clinical feature &diagnosis:


    Symptoms:
    vNo specific symptoms .
    vThese patients have hemorrhagic& thrombotic tendency.
    (easy bruising,microvascular occlusion,).
    Physical examination :
    vusually unremarkable except for the presence of mild
    splenomegally.
    Lab investigation:
    vAnemia is unusual.Mild leukocytosis.
    vBlood smear : most remarkable for the number of PLT.
    vLeukocyte alkaline phosphatase is either normal or.

    Sign & Symptom


    Thrombocyte >>

    50-60 years old

    ET
    Venous thrombosis:
    hepatic, portal & mesenteric

    Initial sign:
    Thrombosis

    Pain & erythema


    of the hands

    Division of Hematology & Oncology Dept. of Internal Medicine

    Sign & Symptom

    Bleeding: mostly occurred in mucosal


    as a manifestation of thrombocyte defect

    Splenomegaly: occurred in 25% patients

    Division of Hematology & Oncology Dept. of Internal Medicine

    Differential Diagnosis

    I. Reactive thrombocytosis (rarely >1.000.000/ mm3)

    DD

    II. Inflammation (RA, colitis) & chronic infection


    III. PV (hematocryte & RBC mass >>)

    Division of Hematology & Oncology Dept. of Internal Medicine

    Management

    Hydroxy-Urea 0,5 2,0 g / day


    Side effect: neutropenia

    Acetyl Salicylic Acid (ASA)


    to reduce vasomotor symptom
    (eritromelalgia & parestesi)

    Tx

    Anagrelide 2 4 mg / day
    Side effect: cephalgia, anemia,
    periferal edema, congestive heart failure
    Division of Hematology & Oncology Dept. of Internal Medicine

    Management

    Risk for thrombosis


    will be high if
    PLT > 500.000/mm3

    Severe bleeding could


    be reduce by using
    plateletpheresis
    (equipment to discard
    excessive blood)

    Division of Hematology & Oncology Dept. of Internal Medicine

    Complication:

    vVery high platelet counts are associated primarily with


    hemorrhage.
    vPlatelet counts <a million are more often associated with
    thrombosis.
    vFrom the neurological problems migraine-related is the
    commonest(respond to platelet lowering).,Erythromelalgia
    (respond to cyclooxygenase inhibitors).

    Prognosis

    ET: Indolent
    Long-term survival
    Developed country: 15 years after first
    diagnosis
    Major problem: thrombosis
    Late phase: Bone marrow fibrosis,
    splenomegaly / spleen infarction, 5% will be
    transformed into acute leukemia

    Division of Hematology & Oncology Dept. of Internal Medicine

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