Case 13 – update 2

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:

Image

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?

Please reply on Twitter and include #TeamHaem

Please reply on Twitter and always include #teamhaem to allow others to follow your comments. Please join in the debate and learn about haematological problems along the way. The case will continue to  evolve over the coming week so keep checking #teamhaem for more information.

Please note – all cases on TeamHaem are entirely fictional to protect patient confidentiality.

TeamHaem are not a position of authority.  It is an educational platform to allow discussion

About TeamHaem

Online education and discussion about all things haematological
This entry was posted in Myeloproliferative neoplasm, Platelet disorders, Related to other specialities and tagged . Bookmark the permalink.

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