Evaluation of clinic and hematological profile of children with thrombocytosis

Year 2019, , 79 - 84, 21.03.2019

Melahat Melek Oguz , Esma Altınel Açoğlu

https://doi.org/10.18663/tjcl.444674

Cited By: 2

Abstract

Aim: Thrombocytosis
is come across as an unexpected finding in children and usually appears as
reactive thrombocytosis. The objective of this study is to determine the
incidence rate of thrombocytosis in children, the etiologic factors, duration
until normalization of thrombocytosis and the correlation between
thrombocytosis and thrombocyte parameters and other variables.

Material and Methods: The
study included the children between 6 months and 18 years of age who were
admitted to Dr. Sami Ulus Maternity and Children’s Health and Diseases Training and
Research Hospital and were diagnosed as thrombocytosis.

Results: The incidence of
thrombocytosis was found to be 10.8% among 107564 pediatric patients throughout
two years period. Sixty four point five percent of these patients were the
children between ages of 6 months and 2 years. Severe thrombocytosis developed
in 141(1.2%) patients. The most common acute thrombocytosis causes were,
infection in 80 patients (56.8%), anemia in 21 patients (14.9%), autoimmune
diseases in 14 patients (9.9%) respectively. The average normalization of acute
thrombocytosis was 40.2±34 days (3-210). No thromboembolic events were
observed. There was a significant negative correlation between the platelet
number and the MPV (p<0.05, r=-0.214). No correlation was found between
platelet numbers and PDW levels (p=0.95). Statistically significant correlation
was found between the number of platelet and the sedimentation rate (p<0.05,
r=0,233) while no correlation was found between CRP level and thrombocyte
number (p=0.15).

Conclusions: The study showed that
reactive thrombocytosis is a common finding which implies varying underlying
reasons. In our sample of patients primary thrombocytosis was never observed.
For this reason the differential diagnosis and treatment of thrombocytosis can
be evaluated by basic pediatric approach and hematology consultation is rarely
needed. Especially in acute thrombocytosis if there is no observable infection
or anemia the underlying causes can be the chronic inflammatory diseases.

Keywords

thrombocytosis, primary etiology, secondary etiology

Trombositoz saptanan çocuklarda klinik ve hematolojik profilin değerlendirilmesi

Abstract

Amaç: Trombositoz çocuklarda beklenmeyen bir bulgu olarak
karşımıza çıkmakta ve daha çok reaktif trombositoz görülmektedir.Bu çalışmanın amacı çocuklarda
trombositozun; sıklığını, nedenlerini, düzelme süresini, trombosit
parametreleri ve enfeksiyon belirteçleri ile korelasyonunu belirlemektir.

Gereç ve Yöntemler:Ekim 2016 ile Mayıs 2018 tarihleri
arasında Dr. Sami Ulus Kadın Doğum ve Çocuk Sağlığı ve Hastalıkları Eğitim ve
Araştırma Hastanesinde 6 ay 18 yaş arası trombositoz saptanan çocukların dahil
edildiği tanımlayıcı bir çalışmadır.

Bulgular: Toplam 107564 hastanın %10,8 (n=11643)’inde
trombositoz saptandı. Bu hastaların %64,5’i 6ay-2 yaş arası çocuklardan
oluşuyordu. Ciddi trombositozun 141(%1,2) hastada geliştiği görüldü.En sık
ciddi trombositoz nedenleri sırası ile 80 hastada (%56,8) enfeksiyonlar, 21
hastada anemi (%14,9), 14 (%9,9) hastada ise otoimmun hastalıklar idi. Ciddi
trombositozların ortalama düzelme süresi 40,2±34 gün (3-210) olarak hesaplandı.
Hastaların hiçbirinde tromboembolik komplikasyon görülmedi. Trombosit sayısı
ile ortalama trombosit hacmi arasında
istatistiksel olarak anlamlı negatif korelasyon olduğu görüldü (p<0,05,
r=-0,214). Trombosit dağılım genişliği düzeyi ile trombosit sayısı arasında
korelasyon görülmedi (p=0,95). CRP düzeyi ile trombosit sayısı arasında istatistiksel
olarak anlamlı korelasyon saptanmadı (p=0,15).Trombosit sayısı ile
sedimantasyon hızı arasında ise istatistiksel olarak anlamlı korelasyon bulundu
(p<0,05, r=0,233). 

Sonuç: Çalışmamızda reaktif trombositozun sık rastlanılan
bir bulgu olduğunu ve bu büyük örneklemde primer trombositozun hiç görülmediğini, sekonder trombositozda altta yatan birçok farklı nedenin olabileceğini saptadık. Dolayısı
ile trombositozun ayırıcı tanısı ve yaklaşımı pediatri uzmanı tarafından
yapılmalıdır ve hematoloji bölümü konsültasyonu nadiren gerekmektedir. Özellikle
ciddi trombositozlarda gösterebildiğimiz enfeksiyon veya anemi yoksa kronik
inflamatuar hastalıkların altta yatan neden olabileceği unutulmamalıdır.

Keywords

Trombositoz, primer etyoloji, sekonder etyoloji

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