Matsubara Kousaku, Fukaya Takashi, Nigami Hiroyuki, Harigaya Hidekazu, Hirata Takuya, Nozaki Hideo, Baba Kunizo
Department of Pediatrics, Nishi-Kobe Medical Center, Kobe, Japan.
Acta Haematol. 2004;111(3):132-7. doi: 10.1159/000076520.
To determine the incidence and etiology of childhood thrombocytosis, over 15,000 platelet counts in 7,539 patients performed at a single regional hospital were reviewed. When thrombocytosis was defined as > or =500 x 10(9)/l of platelet counts, the condition could be diagnosed in 6.0% (456 cases) of the patients. All patients were classified as having secondary thrombocytosis. The incidence of thrombocytosis dramatically changed throughout child development; it was 12.5% in neonates, peaked to 35.8% in 1-month-old infants and then returned to 12.9% in 6- to 11-month-old infants. Thereafter, it gradually decreased with age to only 0.6% in 11- to 15-year-old children. Frequent causes of thrombocytosis included infection (67.5%), Kawasaki disease (9.4%), prematurity (7.7%) and iron deficiency anemia (6.4%). Thrombocytosis was an incidental finding in a substantial population of early infants. Thrombocytosis as a reaction to several types of infection and Kawasaki disease was more common in children under 7 years old, while autoimmune disease and tissue damage were major causes in children aged 11-15 years. No child had thromboembolic complications. These findings indicate that childhood thrombocytosis is a benign condition and its incidence and etiology seem to depend on age.
为确定儿童血小板增多症的发病率和病因，我们回顾了一家地区医院对7539例患者进行的超过15000次血小板计数。当血小板增多症定义为血小板计数≥500×10⁹/L时，6.0%（456例）的患者可诊断为此病。所有患者均被归类为继发性血小板增多症。血小板增多症的发病率在儿童发育过程中显著变化；新生儿中为12.5%，1个月大婴儿中达到峰值35.8%，然后在6至11个月大婴儿中降至12.9%。此后，随着年龄增长逐渐下降，在11至15岁儿童中仅为0.6%。血小板增多症的常见原因包括感染（67.5%）、川崎病（9.4%）、早产（7.7%）和缺铁性贫血（6.4%）。血小板增多症在大量早期婴儿中是偶然发现。作为对几种感染类型和川崎病反应的血小板增多症在7岁以下儿童中更常见，而自身免疫性疾病和组织损伤是11至15岁儿童的主要病因。没有儿童发生血栓栓塞并发症。这些发现表明儿童血小板增多症是一种良性病症，其发病率和病因似乎取决于年龄。
