Subramaniam Nathiya, Mundkur Suneel, Kini Pushpa, Bhaskaranand Nalini, Aroor Shrikiran
Department of Paediatrics, Kasturba Medical College, Manipal University, Manipal, Karnataka 576104, India.
ISRN Hematol. 2014 Jan 29;2014:389257. doi: 10.1155/2014/389257. eCollection 2014.
Introduction. Primary thrombocytosis is very rare in children; reactive thrombocytosis is frequently observed in children with infections, anemia, and many other causes. Aims and Objectives. To identify the etiology of thrombocytosis in children and to analyze platelet indices (MPV, PDW, and PCT) in children with thrombocytosis. Study Design. A prospective observational study. Material and Methods. A total of 1000 patients with thrombocytosis (platelet > 400 × 10(9)/L) were studied over a period of 2 years. Platelet distribution width (PDW), mean platelet volume (MPV), and plateletcrit (PCT) were noted. Results. Of 1000 patients, 99.8% had secondary thrombocytosis and only two children had primary thrombocytosis (chronic myeloid leukemia and acute myelogenous leukemia, M7). The majority of the children belonged to the age group of 1month to 2 years (39.7%) and male to female ratio was 1.6 : 1. Infection with anemia (48.3%) was the most common cause of secondary thrombocytosis followed by iron deficiency alone (17.2%) and infection alone (16.2%). Respiratory infection (28.3%) was the predominant infectious cause observed. Thrombocytosis was commonly associated with IDA among all causes of anemia and severity of thrombocytosis increased with severity of anemia (P = 0.021). With increasing platelet count, there was a decrease in MPV (<0.001). Platelet count and mean PDW among children with infection and anemia were significantly higher than those among children with infection alone and anemia alone. None were observed to have thromboembolic manifestations. Conclusions. Primary thrombocytosis is extremely rare in children than secondary thrombocytosis. Infections in association with anemia are most commonly associated with reactive thrombocytosis and severity of thrombocytosis increases with severity of anemia.
引言。原发性血小板增多症在儿童中非常罕见；反应性血小板增多症在患有感染、贫血及许多其他病因的儿童中较为常见。目的。确定儿童血小板增多症的病因，并分析血小板增多症患儿的血小板指数（平均血小板体积、血小板分布宽度和血小板压积）。研究设计。一项前瞻性观察性研究。材料与方法。在2年的时间里，共研究了1000例血小板增多症患者（血小板>400×10⁹/L）。记录血小板分布宽度（PDW）、平均血小板体积（MPV）和血小板压积（PCT）。结果。在这1000例患者中，99.8%患有继发性血小板增多症，只有两名儿童患有原发性血小板增多症（慢性髓性白血病和急性髓性白血病，M7型）。大多数儿童年龄在1个月至2岁之间（39.7%），男女比例为1.6∶1。感染合并贫血（48.3%）是继发性血小板增多症最常见的原因，其次是单纯缺铁（17.2%）和单纯感染（16.2%）。观察到的主要感染原因是呼吸道感染（28.3%）。在所有贫血病因中，血小板增多症常与缺铁性贫血相关，且血小板增多症的严重程度随贫血严重程度增加而增加（P = 0.021）。随着血小板计数增加，MPV降低（<0.001）。感染合并贫血患儿的血小板计数和平均PDW显著高于单纯感染和单纯贫血患儿。未观察到血栓栓塞表现。结论。儿童原发性血小板增多症比继发性血小板增多症极为罕见。感染合并贫血最常与反应性血小板增多症相关，且血小板增多症的严重程度随贫血严重程度增加而增加。
