The team have asked for some previous results.  Pre operatively the patient’s blood count was:

• Hb 110g/L
• MCV 90fL
• WCC 6.8×10*9/L
• Neutrophils 3.9×10*9/L
• Platelets 189×10*9/L
• Ferritin 182µmol/L (normal)

Previous results have been similar in the not too distant past.

The blood film is shown below:

Most of the #teamhaem followers think this is a ‘reactive’ or secondary thrombocytosis and quite rightly have identified a number of common causes of this:

• Inflammation/sepsis
• Bleeding
• Iron deficiency
• Tissue damage/surgery
• Hyposplenism/splenectomy
• Malignancy

Questions:

• Can you describe the blood film?
• How do you manage or treat secondary thrombocytosis?
• The surgical registrar is keen to start aspirin as he has a previous history of hypertension and hypercholesterolaemia and is worried about ischaemic events.  What do you advise?

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