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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