Why do I have elevated platelet levels?

Q. What does elevated platelet level indicate?

Answered by
Dr. Mubashir Razzaq Khan
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Dec 22, 2020 and last reviewed on: Jul 27, 2023

Hi doctor,

My platelets were 468 last month, and I repeated another full CBC. Everything else was fine, but my platelets were still 463 a month later. Is this something to worry about?

I have fatty liver grade 1 and mild IBS. I also had a Coronavirus infection two months ago. Currently, I am on multivitamins.



Welcome to icliniq.com.

Elevated platelets indicate the following conditions:

Grade 1 thrombocytosis: Platelets 550 to 649.

Grade 2 thrombocytosis: Platelets 650 to 749.

Grade 3 thrombocytosis: Platelets 750 to 849.

Grade 4 thrombocytosis: Platelets 850 to 1099.

Grade 5 thrombocytosis: Platelets 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. To rule out the causes of secondary thrombocytosis. If all causes are excluded, get JAK2 (Janus kinase 2), Exon 12, 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 thousand.

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 on this model. 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.

Your platelets are touching borderline. Just follow up every six months and keep taking Aspirin 75 mg/day.

Thank you doctor,

What is it in my case?



Welcome back to icliniq.com.

Please get CRP (C-reactive protein), ESR (erythrocyte sedimentation rate), ferritin, ANA (anti-nuclear antibodies) by immunofluorescence test to rule out the possible causes. If these tests are inconclusive, no need to investigate further. Just follow up that count.

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