Managing uncontrolled postsplenectomy reactive thrombocytosis in idiopathic thrombocytopenic purpura: role of thrombocytapheresis.

Abstract

Reactive thrombocytosis occurs in response to infection, trauma, or surgery. Splenectomy alone accounts for 19% of all possible causes of extreme thrombocytosis. We performed thrombocytapheresis in a young lady with chronic idiopathic thrombocytopenic purpura (ITP) who developed postsplenectomy reactive thrombocytosis. Her post splenectomy platelet count was 227 × 10(6)/ml which elevated to 1623 × 10(6)/ml on the 7th postoperative day. A single thrombocytapheresis procedure reduced her platelet to 403 × 10(6)/ml. She was discharged on the 10th postoperative day and then maintained a count of 204-238 × 10(6)/ml with aspirin. Thrombocytapheresis reduces the platelet count rapidly in thrombocytosis and prevents patients from having thrombotic events. However, such procedures should be performed very meticulously to ensure patient safety.

• Authors: Sudipta Sekhar Das, Soumya Bhattacharya, Subrata Sen
• Journal: Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis (Transfus Apher Sci) Vol. 49 Issue 2 Pg. 171-3 (Oct 2013) ISSN: 1473-0502 [Print] England
• PMID: 23871583 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2013 Elsevier Ltd. All rights reserved.

Topics

• Adult
• Female
• Humans
• Plateletpheresis
• Postoperative Complications (etiology, therapy)
• Purpura, Thrombocytopenic (pathology, surgery)
• Splenectomy (adverse effects)
• Thrombocytosis (etiology, therapy)
• Time Factors