Essential thrombocytosis laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Soujanya Thummathati, MBBS [2]


Laboratory findings consistent with the diagnosis of essential thrombocytosis include abnormal complete blood count (elevated platelet count, leukocytosis, erythrocytosis), peripheral blood smear showing large platelets, megakaryocyte fragments and platelet aggregates, presence of JAK2 mutation, and absence of BCR-ABL or Philadelphia chromosome.[1][2]

Laboratory findings

Essential thrombocytosis remains a diagnosis of exclusion, after ruling out reactive or secondary causes of thrombocytosis. Laboratory tests for the diagnosis of essential thrombocytosis include the following:[1]

  • Complete blood count (CBC)
  • Peripheral blood smear shows large platelets, megakaryocyte fragments and platelet aggregates.[2]
  • To rule out inflammatory disorders
    • Erythrocyte sedimentation rate (ESR) (normal in essential thrombocytosis)
    • C-reactive protein (CRP) (normal in essential thrombocytosis)
    • Fibrinogen (normal in essential thrombocytosis)
  • To rule out iron deficiency and polycythemia vera
    • Serum ferritin (normal in essential thrombocytosis)
    • Hematocrit (normal in essential thrombocytosis)

Genetic Testing

  • To rule out other myeloproliferative neoplasms
  • To check for genetic mutations
    • JAK2 mutation using PCR


  1. 1.0 1.1 Sanchez S, Ewton A (2006). "Essential thrombocythemia: a review of diagnostic and pathologic features". Arch Pathol Lab Med. 130 (8): 1144–50. doi:10.1043/1543-2165(2006)130[1144:ET]2.0.CO;2. PMID 16879015.
  2. 2.0 2.1 Essential Thrombocythemia. Merck manual. Accessed on November 11,2015.

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