Essential thrombocytosis laboratory findings: Difference between revisions
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==Overview== | ==Overview== | ||
Laboratory findings consistent with the diagnosis of essential thrombocytosis include abnormal | 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]].<ref name="pmid16879015">{{cite journal| author=Sanchez S, Ewton A| title=Essential thrombocythemia: a review of diagnostic and pathologic features. | journal=Arch Pathol Lab Med | year= 2006 | volume= 130 | issue= 8 | pages= 1144-50 | pmid=16879015 | doi=10.1043/1543-2165(2006)130[1144:ET]2.0.CO;2 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16879015 }} </ref><ref name=re>Essential Thrombocythemia. Merck manual. http://www.merckmanuals.com/professional/hematology-and-oncology/myeloproliferative-disorders/essential-thrombocythemia. Accessed on November 11,2015.</ref>. Bone marrow biopsy is an important test. needed in the diagnosis of essential thrombocytosis.<ref name="pmidhttp://dx.doi.org/10.1182/blood-2007-04-083501">{{cite journal| author=Schmoldt A, Benthe HF, Haberland G| title=Digitoxin metabolism by rat liver microsomes. | journal=Biochem Pharmacol | year= 1975 | volume= 24 | issue= 17 | pages= 1639-41 | pmid=http://dx.doi.org/10.1182/blood-2007-04-083501 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10 }} </ref> | ||
==Laboratory findings== | ==Laboratory findings== | ||
Essential thrombocytosis remains a diagnosis of exclusion | 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:<ref name="pmid16879015">{{cite journal| author=Sanchez S, Ewton A| title=Essential thrombocythemia: a review of diagnostic and pathologic features. | journal=Arch Pathol Lab Med | year= 2006 | volume= 130 | issue= 8 | pages= 1144-50 | pmid=16879015 | doi=10.1043/1543-2165(2006)130[1144:ET]2.0.CO;2 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16879015 }} </ref> | ||
*Complete blood count ([[CBC]]) | *Complete blood count ([[CBC]]) | ||
**Elevated platelet count | **Elevated platelet count | ||
**[[Leukocytosis]] | **[[Leukocytosis]] and [[erythrocytosis]] may be present | ||
*Peripheral blood smear shows large platelets, megakaryocyte fragments and platelet aggregates<ref name=re>Essential Thrombocythemia. Merck manual. http://www.merckmanuals.com/professional/hematology-and-oncology/myeloproliferative-disorders/essential-thrombocythemia. Accessed on November 11,2015.</ref> | **Red cells are [[normocytic]] and [[normochromic]], unless the patient had significant hemorrhage. | ||
*Peripheral blood smear shows large platelets, megakaryocyte fragments and platelet aggregates.<ref name=re>Essential Thrombocythemia. Merck manual. http://www.merckmanuals.com/professional/hematology-and-oncology/myeloproliferative-disorders/essential-thrombocythemia. Accessed on November 11,2015.</ref> | |||
*To rule out inflammatory disorders | *To rule out inflammatory disorders | ||
**Erythrocyte sedimentation rate ([[ESR]]) | **Erythrocyte sedimentation rate ([[ESR]]) (normal in essential thrombocytosis) | ||
**C-reactive protein ([[CRP]]) | **C-reactive protein ([[CRP]]) (normal in essential thrombocytosis) | ||
**[[Fibrinogen]] | **[[Fibrinogen]] (normal in essential thrombocytosis) | ||
*To rule out iron deficiency and [[polycythemia vera]] | *To rule out iron deficiency and [[polycythemia vera]] | ||
**Serum [[ferritin]] | **Serum [[ferritin]] (normal in essential thrombocytosis) | ||
**[[Hematocrit]] | **[[Hematocrit]] (normal in essential thrombocytosis) | ||
==Genetic Testing== | |||
*To rule out other myeloproliferative neoplasms | *To rule out other myeloproliferative neoplasms | ||
**''BCR-ABL'' or [[Philadelphia chromosome]] | **''BCR-ABL'' or [[Philadelphia chromosome]] | ||
* | *To check for genetic mutations | ||
**''JAK2'' mutation using [[PCR]] | **''JAK2'' mutation using [[PCR]] | ||
Revision as of 16:59, 5 January 2016
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Soujanya Thummathati, MBBS [2]
Overview
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]. Bone marrow biopsy is an important test. needed in the diagnosis of essential thrombocytosis.[3]
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)
- Elevated platelet count
- Leukocytosis and erythrocytosis may be present
- Red cells are normocytic and normochromic, unless the patient had significant hemorrhage.
- 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
- BCR-ABL or Philadelphia chromosome
- To check for genetic mutations
- JAK2 mutation using PCR
References
- ↑ 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.
- ↑ 2.0 2.1 Essential Thrombocythemia. Merck manual. http://www.merckmanuals.com/professional/hematology-and-oncology/myeloproliferative-disorders/essential-thrombocythemia. Accessed on November 11,2015.
- ↑ Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID http://dx.doi.org/10.1182/blood-2007-04-083501 Check
|pmid=value (help).