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Why are my husband's platelet counts rising?

Q: Why is my husband's platelet count going up, despite close monitoring by doctors? He had an angioplasty and stenting 10 days back. His platelet count was OK before his angioplasty. Today it was 9.1 lakh/mm.

A:The normal platelet count ranges from 150-400 X 103/ml and if it exceeds the upper limit, it is called thrombocytosis. This may be either primary or secondary. Primary thrombocytosis is a neoplastic disorder due to autonomous production of platelets unregulated by the physiologic feedback mechanism to keep the count within the reference range. Secondary or reactive or benign thrombocytosis is an exaggerated physiologic response to an underlying primary problem in response to various stimuli, including systemic infections, inflammatory conditions, bleeding, and tumours. This is caused by the overproduction of chemicals called cytokines that occur in chronic inflammatory states, infections or malignancy. Reactive thrombocytosis is a benign condition, is usually transient and subsides when the primary stimulus ceases. Most patients are asymptomatic and are identified on routine blood counts or the patients may have symptoms of the underlying disorder that may have led to the reactive thrombocytosis. Despite very high counts (>1,000,000 per ml), thrombotic and/or haemorrhagic complications are rare but extremely high platelet count may sometimes require treatment with aspirin to reduce the risk of unusual vascular complications.

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