Thrombocytosis differential diagnosis: Difference between revisions

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Revision as of 17:02, 29 August 2018

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]

Overview

Thrombocytosis Differential Diagnosis

Differentiating the diseases that can cause thrombocytosis :

Category	Condition		Etiology	Mechanism			Inherited	Acquried	Clinical manifestations									Para−clinical findings								Gold standard	Associated findings
									Demography	History	Symptoms			Signs				Para−clinical findings
											Symptoms			Signs				Lab Findings							Imaging
											Fever	Appearance	Bleeding	BP	Splenomegaly	Jaundice	Other	CBC			PBS	Bone marrow exam	PT	PTT
				Increased megakaryocyte proliferation	Accelerated platelet release	Reduced platelet turnover					Fever	Appearance	Bleeding	BP	Splenomegaly	Jaundice	Other	Plt	HB	WBC	PBS	Bone marrow exam	PT	PTT
Autonomous thrombocytosis	Hematologic malignancies	Essential thrombocythemia^[1]	Acquired mutation of JAK2, CALR, or MPL	+	-	-	-	+	Mean age >60 years old, female > male	Vascular occlusive events and hemorrhages	±	Flushing	+	Nl	+	-	Erythromelalgia Transient ischemic attacks Priapism Decreased visual acuity	↑↑	↑	↑	Large platelets Megakaryocyte fragments Platelet aggregates	Increased cellularity Hyperplasia and clustering of megakaryocytes Bone marrow reticulin may be increased with no collagen fibrosis	Nl	Nl	Splenomegaly on abdominal CT VTE on spiral chest CT DVT on ultrasound	Bone marrow biopsy	Thrombo-hemorrhagic complications
		Polycythemia vera^[2]	Acquired mutation of JAK2	+	-	-	-	+	Mean age >60 years old		-	Facial plethora	±	Nl	+	-	Erythromelalgia Pruritus Tinnitus Blurred vision Lymphadenopathy	↑	↑↑	↑	Panmyelosis including prominent erythroid, granulocyte, and megakaryocyte proliferation	Panmyelosis including prominent erythroid, granulocyte, and megakaryocyte proliferation Pleomorphic, mature megakaryocytes	↑	↑		Bone marrow biopsy	Thrombo-hemorrhagic complications
		Primary myelofibrosis^[3]	Bone marrow fibrosis Mutation in JAK2, CALR, or MPL	+	-	-	-	+	Mean age >60 years old, male> female		-	Pallor Bruising Skin nodules	+	Nl	+	+	Fatigue Abdominal pain Early satiety Dyspnea Lymphadenopathy	↑/↓	↓	↓	Decreased number of erythroid, granulocyte, and megakaryocyte proliferation	Proliferation and atypia of megakaryocytes Reticulin or collagen fibrosis Hypercellular bone marrow	↑	↑	Diffuse bone sclerosis on CT	Bone marrow biopsy	Thrombo-hemorrhagic complications Variable risk for development of acute leukemia
		Chronic myeloid leukemia^[4]	Translocation (9;22), the Philadelphia chromosome BCR-ABL1 oncogene	+	-	-	-	+	Mean age >50 years old, male> female		+	Pallor Bruises Petechiae Ulcers Vesicles	+	Nl	+	-	Fatigue Abdominal pain Early satiety Dyspnea Lymphadenopathy	↑	↓	↑	Immature leukocytes Leukemic blasts Leukoerythroblastic features Giant platelets Blast crisis	↑ Proportion of metamyelocytes and other white blood cells at various stages of maturation	↑	↑	Enlarged lymph nodes and splenomegaly on CT scan	Bone marrow biopsy	Increase of immature myeloid cells
		Acute myeloid leukemia		+	-	-	-	+		History of hematological disorder History of chemotherapy and ionizing radiation	+	Pallor Leukemia cutis Bruising Petechiae Ecchymosis	+	Nl	+	+	Fatigue Bone tenderness Early satiety	↑/↓	↓	↑/↓	Leukemic blasts Leukoerythroblastic features Giant platelets	Leukemic cells	↑	↑
		Myelodysplastic syndromes^[5]	Unknown Mutation	+	-	-	-/+	+	Elderly	Exposure to Chemotherapy Radiation therapy Tobacco smoke	+/-	Petechiae, purpura, diffuse erythematous rash	+	Nl	+	+	Shortness of breath Fatigue	↑/↓	↓	↓	Large platelets Ovalomacrocytosis Basophilic stippling Howell-Jolly body Pelger-Huet anomaly Ring sideroblasts	Impaired myeloid maturation Dyserythropoiesis Dysgranulopoiesis Dysmegakaryocytopoiesis Hypercellular bone marrow Fibrosis	Nl	Nl	NA	Bone marrow examination + clinical manifestation	Thrombosis at unusual sites Thrombosis in younger patients Might transformed to acute leukemia
	Condition		Etiology	Increased megakaryocyte proliferation	Accelerated platelet release	Reduced platelet turnover	Inherited	Acquried	Demography	History	Fever	Appearance	Bleeding	BP	Splenomegaly	Jaundice	Other signs	Plt	HB	WBC	PBS	Bone marrow exam	PT	PTT	Imaging	Gold standard	Associated findings
	Familial thrombocytosis		Mutation in TPO and MPL	+	-	-	+	-										↑	Nl	Nl	Giant platelets Platelet conglomerates Bizarre forms Megakaryocytic fragments Platelet hypogranularity						Mendelian inheritance High penetrance Polyclonal hematopoiesis
Reactive thrombocytosis	Anemia/ blood loss	Iron deficiency Blood loss Hemolysis		+						History of bleeding or iron deficiency								↑	↓								Required iron studies
	Infection	Chronic infections		+	+													↑		↑
		Tuberculosis		+	+													↑		↑
		Acute bacterial and viral infections		+	+													↑		↑
	Inflammation	Vasculitides		+	+													↑		↑
		Acute pancreatitis		+	+													↑		↑
		Malignancy		+	+													↑		↑
	Condition		Etiology	Increased megakaryocyte proliferation	Accelerated platelet release	Reduced platelet turnover	Inherited	Acquried	Demography	History	Fever	Appearance	Bleeding	BP	Splenomegaly	Jaundice	Other signs	Plt	HB	WBC	PBS	Bone marrow exam	PT	PTT	Imaging	Gold standard	Associated findings
	Tissue damage	Thermal burns																↑
		Trauma																↑
		Myocardial infarction																↑
	Medication	Myelosuppressive agents																↑
		Vincristine																↑
		Epinephrine, glucocorticoids																↑
		Interleukin-1B																↑
		All-trans retinoic acid																↑
		Thrombopoietin																↑
	Other	Post-splenectomy or functional asplenia				+				Prior surgical removal of the spleen Sickle cell disease								↑			Howell-Jolly bodies Nucleated RBCs
		Allergic reactions																↑
		Exercise																↑
	Pseudothrombocytosis	Mixed cryoglobulinemia
	Pseudothrombocytosis	Cytoplasmic fragments
Category	Condition		Etiology	Increased megakaryocyte proliferation	Accelerated platelet release	Reduced platelet turnover	Inherited	Acquried	Demography	History	Fever	Appearance	Bleeding	BP	Splenomegaly	Jaundice	Other signs	Plt	HB	WBC	PBS	Bone marrow exam	PT	PTT	Imaging	Gold standard	Associated findings

References

↑ Brière, Jean B (2007). Orphanet Journal of Rare Diseases. 2 (1): 3. doi:10.1186/1750-1172-2-3. ISSN 1750-1172. Missing or empty |title= (help)
↑ Arber, D. A.; Orazi, A.; Hasserjian, R.; Thiele, J.; Borowitz, M. J.; Le Beau, M. M.; Bloomfield, C. D.; Cazzola, M.; Vardiman, J. W. (2016). "The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia". Blood. 127 (20): 2391–2405. doi:10.1182/blood-2016-03-643544. ISSN 0006-4971.
↑ Tefferi, Ayalew; Lasho, Terra L.; Jimma, Thitina; Finke, Christy M.; Gangat, Naseema; Vaidya, Rakhee; Begna, Kebede H.; Al-Kali, Aref; Ketterling, Rhett P.; Hanson, Curtis A.; Pardanani, Animesh (2012). "One Thousand Patients With Primary Myelofibrosis: The Mayo Clinic Experience". Mayo Clinic Proceedings. 87 (1): 25–33. doi:10.1016/j.mayocp.2011.11.001. ISSN 0025-6196.
↑ Thompson, Philip A.; Kantarjian, Hagop M.; Cortes, Jorge E. (2015). "Diagnosis and Treatment of Chronic Myeloid Leukemia in 2015". Mayo Clinic Proceedings. 90 (10): 1440–1454. doi:10.1016/j.mayocp.2015.08.010. ISSN 0025-6196.
↑ Natelson, Ethan A.; Pyatt, David (2013). "Acquired Myelodysplasia or Myelodysplastic Syndrome: Clearing the Fog". Advances in Hematology. 2013: 1–11. doi:10.1155/2013/309637. ISSN 1687-9104.

[Brière2007-1] Brière, Jean B (2007). Orphanet Journal of Rare Diseases. 2 (1): 3. doi:10.1186/1750-1172-2-3. ISSN 1750-1172. Missing or empty |title= (help)

[ArberOrazi2016-2] Arber, D. A.; Orazi, A.; Hasserjian, R.; Thiele, J.; Borowitz, M. J.; Le Beau, M. M.; Bloomfield, C. D.; Cazzola, M.; Vardiman, J. W. (2016). "The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia". Blood. 127 (20): 2391–2405. doi:10.1182/blood-2016-03-643544. ISSN 0006-4971.

[TefferiLasho2012-3] Tefferi, Ayalew; Lasho, Terra L.; Jimma, Thitina; Finke, Christy M.; Gangat, Naseema; Vaidya, Rakhee; Begna, Kebede H.; Al-Kali, Aref; Ketterling, Rhett P.; Hanson, Curtis A.; Pardanani, Animesh (2012). "One Thousand Patients With Primary Myelofibrosis: The Mayo Clinic Experience". Mayo Clinic Proceedings. 87 (1): 25–33. doi:10.1016/j.mayocp.2011.11.001. ISSN 0025-6196.

[ThompsonKantarjian2015-4] Thompson, Philip A.; Kantarjian, Hagop M.; Cortes, Jorge E. (2015). "Diagnosis and Treatment of Chronic Myeloid Leukemia in 2015". Mayo Clinic Proceedings. 90 (10): 1440–1454. doi:10.1016/j.mayocp.2015.08.010. ISSN 0025-6196.

[NatelsonPyatt2013-5] Natelson, Ethan A.; Pyatt, David (2013). "Acquired Myelodysplasia or Myelodysplastic Syndrome: Clearing the Fog". Advances in Hematology. 2013: 1–11. doi:10.1155/2013/309637. ISSN 1687-9104.

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@@ Line 17: / Line 17: @@
 ! rowspan="5" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Acquried
 ! colspan="9" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Clinical manifestations
-! colspan="9" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Para−clinical findings
+! colspan="8" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Para−clinical findings
 ! colspan="1" rowspan="5" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Gold standard
 ! rowspan="5" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Associated findings
@@ Line 26: / Line 26: @@
 | colspan="4" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Signs
 |-
-! colspan="8" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab Findings
+! colspan="7" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab Findings
 ! rowspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging
 |-
 ! colspan="1" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Fever
-! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Rash
+! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Appearance
 ! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Bleeding
 ! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |BP
@@ Line 41: / Line 41: @@
 ! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |PT
 ! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |PTT
-! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |UA
 |-
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Increased megakaryocyte proliferation
@@ Line 50: / Line 49: @@
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |WBC
 |-
-! rowspan="7" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Autonomous thrombocytosis
+! rowspan="8" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Autonomous thrombocytosis
 ! rowspan="6" align="center" style="background:#DCDCDC;" |Hematologic malignancies
-! align="center" style="background:#DCDCDC;" |[[Essential thrombocytosis|Essential thrombocythemia]]
+! align="center" style="background:#DCDCDC;" |[[Essential thrombocytosis|Essential thrombocythemia]]<ref name="Brière2007">{{cite journal|last1=Brière|first1=Jean B|journal=Orphanet Journal of Rare Diseases|volume=2|issue=1|year=2007|pages=3|issn=17501172|doi=10.1186/1750-1172-2-3}}</ref>
 | align="center" style="background:#F5F5F5;" + |
-* Acquired mutation of ''JAK2, CALR,'' or ''MPL''
+* Acquired mutation of ''[[Janus kinase|JAK2]], CALR,'' or ''MPL''
 | align="center" style="background:#F5F5F5;" + | +
 | align="center" style="background:#F5F5F5;" + | -
@@ Line 60: / Line 59: @@
 | align="center" style="background:#F5F5F5;" + | -
 | align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |Mean age >60 years old, female > male
 | align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
+* Vascular occlusive events and [[Bleeding|hemorrhages]]
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |±
 | align="center" style="background:#F5F5F5;" + |Flushing
+| align="center" style="background:#F5F5F5;" + |+
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |-
 | align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
+* [[Erythromelalgia]]
-| align="center" style="background:#F5F5F5;" + |
+* [[Transient ischemic attack|Transient ischemic attacks]]
-| align="center" style="background:#F5F5F5;" + |
+* [[Priapism]]
-| align="center" style="background:#F5F5F5;" + |
+* Decreased [[visual acuity]]
-* Erythromelalgia
+| align="center" style="background:#F5F5F5;" + |↑↑
+| align="center" style="background:#F5F5F5;" + |↑
 | align="center" style="background:#F5F5F5;" + |↑
 | align="center" style="background:#F5F5F5;" + |
+* Large [[Platelet|platelets]]
+* [[Megakaryocyte]] fragments
+* [[Platelet]] aggregates
 | align="center" style="background:#F5F5F5;" + |
+* Increased cellularity
+* Hyperplasia and clustering of megakaryocytes
+* Bone marrow [[reticulin]] may be increased with no [[collagen]] fibrosis
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |Nl
 | align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
+* [[Splenomegaly]] on abdominal CT
-| align="center" style="background:#F5F5F5;" + |
+* [[VTE]] on spiral chest CT
-| align="center" style="background:#F5F5F5;" + |
+* [[Deep vein thrombosis|DVT]] on ultrasound
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |[[Bone marrow examination|Bone marrow biopsy]]
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
 * Thrombo-hemorrhagic complications
 |-
-! align="center" style="background:#DCDCDC;" |[[Polycythemia vera]]
+! align="center" style="background:#DCDCDC;" |[[Polycythemia vera]]<ref name="ArberOrazi2016">{{cite journal|last1=Arber|first1=D. A.|last2=Orazi|first2=A.|last3=Hasserjian|first3=R.|last4=Thiele|first4=J.|last5=Borowitz|first5=M. J.|last6=Le Beau|first6=M. M.|last7=Bloomfield|first7=C. D.|last8=Cazzola|first8=M.|last9=Vardiman|first9=J. W.|title=The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia|journal=Blood|volume=127|issue=20|year=2016|pages=2391–2405|issn=0006-4971|doi=10.1182/blood-2016-03-643544}}</ref>
 | align="center" style="background:#F5F5F5;" + |
 * Acquired mutation of ''JAK2''
@@ Line 95: / Line 106: @@
 | align="center" style="background:#F5F5F5;" + | -
 | align="center" style="background:#F5F5F5;" + |Facial plethora
-| align="center" style="background:#F5F5F5;" + | -
+| align="center" style="background:#F5F5F5;" + |±
 | align="center" style="background:#F5F5F5;" + |Nl
 | align="center" style="background:#F5F5F5;" + | +
 | align="center" style="background:#F5F5F5;" + | -
 | align="center" style="background:#F5F5F5;" + |
-* Erythromelalgia
+* [[Erythromelalgia]]
-* Pruritus
+* [[Itch|Pruritus]]
+* [[Tinnitus]]
+* [[Blurred vision]]
+* [[Lymphadenopathy]]
 | align="center" style="background:#F5F5F5;" + |↑
 | align="center" style="background:#F5F5F5;" + |↑↑
+| align="center" style="background:#F5F5F5;" + |↑
 | align="center" style="background:#F5F5F5;" + |
+* Panmyelosis including prominent [[Red blood cell|erythroid]], [[granulocyte]], and [[megakaryocyte]] proliferation
 | align="center" style="background:#F5F5F5;" + |
+* Panmyelosis including prominent [[Red blood cell|erythroid]], [[granulocyte]], and [[megakaryocyte]] proliferation
+* Pleomorphic, mature [[Megakaryocyte|megakaryocytes]]
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↑
 | align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |[[Bone marrow examination|Bone marrow biopsy]]
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
 * Thrombo-hemorrhagic complications
 |-
-! align="center" style="background:#DCDCDC;" |[[Myelofibrosis|Primary myelofibrosis]]
+! align="center" style="background:#DCDCDC;" |[[Myelofibrosis|Primary myelofibrosis]]<ref name="TefferiLasho2012">{{cite journal|last1=Tefferi|first1=Ayalew|last2=Lasho|first2=Terra L.|last3=Jimma|first3=Thitina|last4=Finke|first4=Christy M.|last5=Gangat|first5=Naseema|last6=Vaidya|first6=Rakhee|last7=Begna|first7=Kebede H.|last8=Al-Kali|first8=Aref|last9=Ketterling|first9=Rhett P.|last10=Hanson|first10=Curtis A.|last11=Pardanani|first11=Animesh|title=One Thousand Patients With Primary Myelofibrosis: The Mayo Clinic Experience|journal=Mayo Clinic Proceedings|volume=87|issue=1|year=2012|pages=25–33|issn=00256196|doi=10.1016/j.mayocp.2011.11.001}}</ref>
 | align="center" style="background:#F5F5F5;" + |
-* Bone marrow fibrosis
+* [[Bone marrow]] fibrosis
-* Mutation in ''JAK2, CALR'', or ''MPL''
+* [[Mutation]] in ''[[Janus kinase|JAK2]], CALR'', or ''MPL''
 | align="center" style="background:#F5F5F5;" + | +
 | align="center" style="background:#F5F5F5;" + | -
@@ Line 124: / Line 140: @@
 | align="center" style="background:#F5F5F5;" + | -
 | align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |Mean age >60 years old, male> female
 | align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | -
+| align="center" style="background:#F5F5F5;" + |[[Pallor]]
+* [[Bruising]]
+* [[Nodules|Skin nodules]]
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + | +
 | align="center" style="background:#F5F5F5;" + |
+* [[Fatigue]]
+* [[Abdominal pain]]
+* Early satiety
+* [[Dyspnea]]
+* [[Lymphadenopathy]]
+| align="center" style="background:#F5F5F5;" + |↑/↓
+| align="center" style="background:#F5F5F5;" + |↓
+| align="center" style="background:#F5F5F5;" + |↓
 | align="center" style="background:#F5F5F5;" + |
+* Decreased number of [[Red blood cell|erythroid]], [[granulocyte]], and [[megakaryocyte]] proliferation
 | align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
+* Proliferation and atypia of [[megakaryocytes]]
-| align="center" style="background:#F5F5F5;" + |
+* Reticulin or [[Collagen|collagen fibrosis]]
-| align="center" style="background:#F5F5F5;" + |
+* Hypercellular [[bone marrow]]
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |↑
 | align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
+* Diffuse bone [[sclerosis]] on [[CT angiography|CT]]
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |[[Bone marrow examination|Bone marrow biopsy]]
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
 * Thrombo-hemorrhagic complications
+*Variable risk for development of [[acute leukemia]]
 |-
-! align="center" style="background:#DCDCDC;" |[[Chronic myelogenous leukemia|Chronic myeloid leukemia]]
+! align="center" style="background:#DCDCDC;" |[[Chronic myelogenous leukemia|Chronic myeloid leukemia]]<ref name="ThompsonKantarjian2015">{{cite journal|last1=Thompson|first1=Philip A.|last2=Kantarjian|first2=Hagop M.|last3=Cortes|first3=Jorge E.|title=Diagnosis and Treatment of Chronic Myeloid Leukemia in 2015|journal=Mayo Clinic Proceedings|volume=90|issue=10|year=2015|pages=1440–1454|issn=00256196|doi=10.1016/j.mayocp.2015.08.010}}</ref>
 | align="center" style="background:#F5F5F5;" + |
-* Translocation (9;22), the Philadelphia chromosome
+* Translocation (9;22), the [[Philadelphia chromosome]]
-* ''BCR-ABL1'' oncogene
+* [[BCR/ABL|''BCR-ABL1'' oncogene]]
 | align="center" style="background:#F5F5F5;" + | +
 | align="center" style="background:#F5F5F5;" + | -
@@ Line 155: / Line 183: @@
 | align="center" style="background:#F5F5F5;" + | -
 | align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |Mean age >50 years old, male> female
 | align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + | +
 | align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
+* [[Pallor]]
-| align="center" style="background:#F5F5F5;" + |
+* [[Bruises]]
-| align="center" style="background:#F5F5F5;" + |
+* [[Petechiae]]
-| align="center" style="background:#F5F5F5;" + |
+* [[Ulcers]]
+* [[Vesicles]]
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |Nl
 | align="center" style="background:#F5F5F5;" + | +
 | align="center" style="background:#F5F5F5;" + | -
 | align="center" style="background:#F5F5F5;" + |
+* [[Fatigue]]
+* [[Abdominal pain]]
+* Early satiety
+* [[Dyspnea]]
+* [[Lymphadenopathy]]
 | align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↓
 | align="center" style="background:#F5F5F5;" + |↑
 | align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
+* Immature [[White blood cells|leukocytes]]
-* Immature leukocytes
 * Leukemic blasts
 * Leukoerythroblastic features
 * Giant platelets
+* Blast crisis
 | align="center" style="background:#F5F5F5;" + |
+* ↑ Proportion of metamyelocytes and other [[white blood cells]] at various stages of maturation
+| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↑
 | align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
+* Enlarged [[Lymph node|lymph nodes]] and [[splenomegaly]] on [[Computed tomography|CT scan]]
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |[[Bone marrow examination|Bone marrow biopsy]]
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
 * Increase of immature myeloid cells
@@ Line 191: / Line 231: @@
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
+* History of hematological disorder
+* History of [[chemotherapy]] and  [[ionizing radiation]]
+| align="center" style="background:#F5F5F5;" + | +
 | align="center" style="background:#F5F5F5;" + |
+* [[Pallor]]
+* [[Chloroma|Leukemia cutis]]
+* [[Bruising]]
+* [[Petechia|Petechiae]]
+* [[Ecchymosis]]
+| align="center" style="background:#F5F5F5;" + | +
+| align="center" style="background:#F5F5F5;" + |Nl
+| align="center" style="background:#F5F5F5;" + |+
+| align="center" style="background:#F5F5F5;" + |+
 | align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
+* [[Fatigue]]
-| align="center" style="background:#F5F5F5;" + |
+* Bone tenderness
-| align="center" style="background:#F5F5F5;" + |
+* Early satiety
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |↑/↓
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |↑
+| align="center" style="background:#F5F5F5;" + |↑/↓
-| align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
 * Leukemic blasts
@@ Line 206: / Line 256: @@
 * Giant platelets
 | align="center" style="background:#F5F5F5;" + |
-| align="center" style="background:#F5F5F5;" + |
+* Leukemic cells
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |
+| align="center" style="background:#F5F5F5;" + |↑
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
@@ Line 253: / Line 303: @@
 * Hypercellular [[bone marrow]]
 * [[Fibrosis]]
-| align="center" style="background:#F5F5F5;" + |Nl
 | align="center" style="background:#F5F5F5;" + |Nl
 | align="center" style="background:#F5F5F5;" + |Nl
@@ Line 262: / Line 311: @@
 * Thrombosis in younger patients
 * Might transformed to [[acute leukemia]]
+|-
+! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Condition
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Etiology
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Increased megakaryocyte proliferation
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Accelerated platelet release
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Reduced platelet turnover
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Inherited
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Acquried
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Demography
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |History
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Fever
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Appearance
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Bleeding
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |BP
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Splenomegaly
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Jaundice
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other signs
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Plt
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |HB
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |WBC
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |PBS
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Bone marrow exam
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |PT
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |PTT
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Gold standard
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Associated findings
 |-
 ! colspan="2" align="center" style="background:#DCDCDC;" |Familial thrombocytosis
@@ Line 289: / Line 365: @@
 * Megakaryocytic fragments
 * Platelet hypogranularity
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
@@ Line 299: / Line 374: @@
 * High penetrance
 * Polyclonal hematopoiesis
-|-
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Category
-! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Condition
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Etiology
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Increased megakaryocyte proliferation
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Accelerated platelet release
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Reduced platelet turnover
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Inherited
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Acquried
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Demography
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |History
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Fever
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Rash
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Bleeding
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |BP
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Splenomegaly
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Jaundice
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other signs
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Plt
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |HB
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |WBC
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |PBS
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Bone marrow exam
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |PT
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |PTT
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |UA
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Gold standard
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Associated findings
 |-
 ! rowspan="20" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Reactive thrombocytosis
@@ Line 354: / Line 400: @@
 | align="center" style="background:#F5F5F5;" + |↑
 | align="center" style="background:#F5F5F5;" + |↓
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
@@ Line 385: / Line 430: @@
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
@@ Line 413: / Line 457: @@
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
@@ Line 441: / Line 484: @@
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
@@ Line 470: / Line 512: @@
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
@@ Line 498: / Line 539: @@
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
@@ Line 526: / Line 566: @@
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
@@ Line 545: / Line 584: @@
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |History
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Fever
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Rash
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Appearance
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Bleeding
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |BP
@@ Line 558: / Line 597: @@
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |PT
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |PTT
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |UA
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Gold standard
@@ Line 581: / Line 619: @@
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
@@ Line 609: / Line 646: @@
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
@@ Line 637: / Line 673: @@
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
@@ Line 666: / Line 701: @@
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
@@ Line 694: / Line 728: @@
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
@@ Line 722: / Line 755: @@
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
@@ Line 750: / Line 782: @@
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
@@ Line 778: / Line 809: @@
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
@@ Line 806: / Line 836: @@
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
@@ Line 842: / Line 871: @@
 * Howell-Jolly bodies
 * Nucleated RBCs
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
@@ Line 867: / Line 895: @@
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
@@ Line 895: / Line 922: @@
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |↑
-| align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
 | align="center" style="background:#F5F5F5;" + |
@@ Line 909: / Line 935: @@
 ! rowspan="2" |Pseudothrombocytosis
 !'''[[Cryoglobulinemia|Mixed cryoglobulinemia]]'''
-!
 !
 !
@@ Line 937: / Line 962: @@
 |-
 !'''Cytoplasmic fragments'''
-!
 !
 !
@@ Line 975: / Line 999: @@
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |History
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Fever
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Rash
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Appearance
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Bleeding
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |BP
@@ Line 988: / Line 1,012: @@
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |PT
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |PTT
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |UA
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Gold standard

Thrombocytosis differential diagnosis: Difference between revisions

Revision as of 17:02, 29 August 2018

Overview

Thrombocytosis Differential Diagnosis

References

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