Q. My platelet count is high and it differs each month. Should I consult a hematologist?

Answered by
Dr. Mubashir Razzaq Khan
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Dec 20, 2020 and last reviewed on: Jan 21, 2021

Hi doctor,

I am a 27-year-old female. I have dyslipidemia and currently taking Lipanthyl. I have been taking blood tests and consult my doctor every month for five months. I manage to reduce my cholesterol, but the doctor is concerned with my platelet count right now. I have attached my blood platelet count for the past five months.

The first month- 506.

The second month - 476.

The third month - 475.

The fourth month - 475.

Current reading - 525.

The doctor has referred me to consult the hematologist. Should I really go consult the hematologist, or is this a normal blood platelet count?

#

Hello,

Welcome to icliniq.com.

In the case of elevated platelets, grade 1 thrombocytosis: platelets range between 550-649.

In grade 2, thrombocytosis: platelets range between 650-749.

Grade 3 thrombocytosis: 750-849.

Grade 4 thrombocytosis: 850-1099.

Grade 5 thrombocytosis: 1100 or more.

Elevated platelets are seen in iron deficiency anemia, infections, inflammation, drug-induced, and very rarely, it could be a part of essential thrombocythemia. Rule out the causes of secondary thrombocytosis. If all causes are excluded, get JAK2, Exon12, and CALR mutations tested. Even in primary thrombocytosis, also called essential thrombocythemia, these mutations are negative frequently.

In cases of secondary thrombocytosis, the treatment of elevated platelets is to treat the cause. In primary thrombocythemia, if JAK2 is negative, the treatment is cytoreductive therapy by hydroxyurea. The goal is to keep platelets below 1000. Thrombolytic drugs such as Aspirin, Clopidogrel, and Warfarin are also a part of therapy.

For JAK2 positive patients, Ruxolitinib tablets are given in a dose of 5 to 15 mg per day. Another option is IFN alpha in low dose (45 ug/week) in both JAK2 positive or negative cases. CALR positive cases show superior results in this mode. It could take years to cure the disease. This is not a life-threatening disease unless thromboembolism involves the heart, lungs, or/and brain. Sometimes, the first manifestation of the disease is thromboembolic events.


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