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Thrombocytosis in childhood
1Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore.
Insights
Secondary thrombocytosis is common and benign in children, often linked to infections like pneumonia or gastroenteritis. Primary thrombocytosis is rare in this age group and typically asymptomatic.
Area of Science:
- Pediatric Hematology
- Clinical Pediatrics
Background:
- Thrombocytosis is frequently observed in infants and children.
- Limited pediatric literature exists on its incidence and clinical significance.
Purpose of the Study:
- To investigate the incidence and clinical significance of thrombocytosis in pediatric patients.
- To identify common causes and outcomes of pediatric thrombocytosis.
Main Methods:
- Prospective study of 10,288 admissions over 18 months.
- Reviewed and followed-up cases with platelet count > 600 x 10(9)/L.
- Serial platelet counts monitored until normalization.
Main Results:
- 135 cases (1.3%) of thrombocytosis identified, predominantly in males and infants under 1 year.
- 78% of cases associated with infection (bacterial: pneumonia; non-bacterial: gastroenteritis, Kawasaki disease).
- Platelet counts normalized within weeks, varying by etiology; no thrombocytosis-associated symptoms observed.
Conclusions:
- Primary thrombocytosis is rare in children.
- Secondary thrombocytosis is a common, benign finding in pediatric patients.
- Infections are the leading cause of secondary thrombocytosis in children.
Introduction:
Thrombocytosis is a common condition in infancy and childhood. There are very few paediatric literature on its incidence and clinical significance.
Method:
We conducted a prospective study over 18 months (January 1993 to June 1994) on all patients admitted with a platelet count done. Cases with platelet count > 600 x 10(9)/L were reviewed and followed-up. Serial platelet count were done at 1 week, 2 weeks, 3 weeks, 4 weeks, and then monthly until it normalised.
Results:
One hundred and thirty-five cases out of 10,288 admissions had raised platelet count. There was a preponderance of male (sex ratio M:F = 1.7:1). Majority was less than 1 year old. Seventy-eight percent had associated infection of which 2/3 were due to bacterial infections, Pneumonia was the most common bacterial infection associated with thrombocytosis whilst gastroenteritis was the most common cause for non-bacterial infection and Kawasaki's disease constituted the majority of the non-infective etiology. Cases with platelet count > 900 x 10(9)/L, 73.3% were due to bacterial infection. Three cases of Kawasaki's disease had platelet counts > 900 x 10(9)/L. Fifty-two percent of cases developed thrombocytosis within 4 days of illness. In nonbacterial infection, the thrombocytosis normalised by about 1 week after onset. For bacterial infection, the thrombocytosis normalised later depending on the severity of infection. In majority of the Kawasaki's disease, the platelet count normalised by the third week.
Conclusion:
Primary thrombocytosis is rare in paediatric age group. None of the cases developed any symptoms associated with thrombocytosis. Secondary thrombocytosis is a benign and common phenomenon in children.