Study on Clinico Etiological Profile on Thrombocytosis in Children

Abstract

Background: With the increased use of electronic cell counters and routine inclusion of platelet counts in blood tests, thrombocytosis is more commonly detected incidentally. Elevated platelet counts have become an important clinical consideration in diagnosing various pathological and physiological conditions.

Aims and Objectives: Our aim is to research the fundamental causes of thrombocytosis and its clinical manifestations in our pediatric group. Objectives: study the clinico-etiological profile of thrombocytosis in children. Secondary objectives: evaluate platelet parameters in primary and secondary thrombocytosis, and study complications associated with thrombocytosis.

Results: Among 200 children studied, 84 (42%) were female and 116 (58%) were male, with a male-to-female ratio of 1.3:1. The mean age was 3.54 years (SD 3.79), primarily between 1-5 years. Fever was the most common symptom (73.5%), followed by cough (51.5%), fast breathing (31%), progressive pallor (23.5%), and gastrointestinal symptoms (16%). Other symptoms included joint swelling (13.5%), rash (3.5%), anasarca (3.5%), and abnormal body movements (4%). In this study, 73.5% had mild thrombocytosis, 15.5% had moderate, and 5.5% had severe/extreme thrombocytosis. Significant correlations were found between thrombocytosis severity, total leukocyte count, and CRP positivity (p=0.01). Mean platelet volume and platelet distribution width decreased with higher platelet counts (p<0.01). Anemia was common (66% had pallor), but hemoglobin levels did not correlate with thrombocytosis severity (p=0.29). All cases were reactive thrombocytosis, mostly due to infections (69.5%), with respiratory infections being most frequent. Other causes included iron deficiency anemia (14%) and autoimmune disorders (7.5%).

Conclusion: Thrombocytosis is common in children, often benign and reactive to conditions like trauma, surgery, infections, or iron deficiency. True myeloproliferative thrombocytosis is rare, affecting 1 in a million. Reactive thrombocytosis usually doesn’t lead to complications. Platelet indices are useful biomarkers for diagnosing and prognosticating infections.