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Published on: December 10, 2013
Reactive thrombocytosis in children with viral respiratory tract infections
K Haidopoulou1, M Goutaki, M Lemonaki
1Fourth Department of Pediatrics, Aristotle University of Thessaloniki, Thessaloniki, Greece. haidoka@auth.gr
Insights
Reactive thrombocytosis is common in children hospitalized with viral lower respiratory tract infections. This condition is a reactive phenomenon and does not indicate bacterial infection or severe illness, negating the need for routine prophylactic treatment.
Area of Science:
- Pediatrics
- Infectious Diseases
- Hematology
Background:
- Secondary thrombocytosis is frequently observed in pediatric patients.
- It is commonly associated with lower respiratory tract infections, more often bacterial than viral.
Purpose of the Study:
- To investigate the incidence of thrombocytosis in children with viral lower respiratory tract infections.
- To determine the clinical significance of thrombocytosis in this pediatric population.
Main Methods:
- Retrospective analysis of clinical data from 92 children (10 days to 8 years) hospitalized with viral lower respiratory tract infection.
- Thrombocytosis defined as a platelet count >500×10^9/L.
Main Results:
- Thrombocytosis was present in 59.78% of patients.
- Children with thrombocytosis were significantly younger (P=0.002).
- Respiratory Syncytial Virus (RSV) infections were associated with higher platelet counts (P=0.003); extreme thrombocytosis (>1000×10^9/L) occurred in 8.7% of patients, primarily infants with RSV bronchiolitis.
Conclusions:
- Reactive thrombocytosis is a common finding in children hospitalized with viral lower respiratory tract infections.
- It is a reactive phenomenon, not indicative of bacterial infection or a severe clinical course.
- Routine prophylactic antiplatelet treatment or further investigations are not necessary.
Aim:
Secondary thrombocytosis occurs commonly in children and is associated with a variety of lower respiratory tract infections, bacterial most often than viral. Aim of the study was to have an insight into the incidence and the clinical significance of thrombocytosis in children with lower respiratory tract infection caused by viral pathogens.
Methods:
Clinical data of 92 children, aged 10 days to 8 years, hospitalized with viral lower respiratory tract infection were studied retrospectively for presence of thrombocytosis (platelet count >500×109/l).
Results:
Thrombocytosis was detected in 59.78% of patients. When children with and without thrombocytosis were compared a significant difference was found for age (P=0.002). We have found no differences among the two groups in sex, SaO2, clinical severity score and CRP levels at admission. Patients with RSV infection presented with significantly higher platelet counts (P=0.003). Extreme thrombocytosis (platelet count >1000×109/L) was noticed in eight patients (8.7%), seven of them were infants with RSV bronchiolitis. All children recovered uneventfully without requiring prophylaxis with anticoagulants or platelet aggregation inhibitors.
Conclusion:
Reactive thrombocytosis is a common finding in the acute care population of children hospitalized with viral lower respiratory tract infection. It represents a reactive phenomenon and does not indicate infection of bacterial cause or severe clinical course. Routine prophylactic antiplatelet treatment or further investigations are not necessary.
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