High Blood Platelet Count in Children
A normal platelet count in children is 150,000 to 400,000 per microliter. When the platelets exceed this amount, it is called thrombocytosis or high blood platelet count.
The causes of high blood platelet count (thrombocytosis) are:
1) Dehydration
2) Brain injury
3) Malignant tumors that are situated in the bone marrow or elsewhere
4) Liver diseases
5) Leukemia.
6) Polycythemia vera
7) Rheumatoid arthritis.
8) Sickle cell anemia
9)Spinal cord injury
10) Trauma
11) Von Willebrand disease
12) Severe infections like malaria
13). Autoimmune disorder (like Graves’ disease etc.)
14) Heavy metal poisoning
15) Iron deficiency
16) Parvovirus
17) Hormonal disorders
18). Vitamin B 12 deficiency
19). Homocystinuria
20). Hyperlipidemia
Symptoms of high blood platelet count in children:
1) Easy bruising
2). Nose bleeds.
3) Bruised gums
4). Blood in urine or stool
5) Heavy periods
6) Painful joints.
7) Itching skin
8). Headaches
9 ). Fatigue
10). Dizziness
11). Fever
12). Fainting or near fainting
13). Bleeding under the skin
14) Nose bleeds.
15). Easy bleeding from cuts
16) Abdominal pain
21) Diarrhea
22). Indigestion
23). Constipation
24) Weight loss
25). Pale, brittle nails
26) Hair loss
27 ). Seizures
28). Facial swelling and/or numbness
29). Red or blue in the whites of the eyes.
30) Swelling of hands and feet
Thrombocytosis in child treatment:
thrombocytosis is a condition in which the blood platelets are increased. Platelets can cause excess clotting, also called hypercoagulation, which may occur with thrombocytosis. Such hypercoagulation of blood results in a greater chance of stroke and heart attack.
Blood disorders may be genetic or acquired:
Acquired: in this case, thrombocytosis is an indication of underlying diseases like:
-Hemophilia: a chronic condition that may cause excessive bleeding.
Artificial heart valves and artificial joints with prostheses.
-Severe liver disease leads to impaired blood clotting.
Ischemic bowel:
it is a rare disorder that causes ischemic bowel disease. This can be due to arterial blockages caused by atherosclerosis after the atheroma ruptures and deposits cholesterol material into the arteries causing blockage or plaque build-up, percutaneous coronary intervention may result in the formation of platelet thrombi and activation of these particles can lead to increased bleeding and stroke.
Thrombocytosis in child treatment:
There are different types of childhood thrombocytosis. The most common form is known as reactive thrombocythemia, which is when the platelet levels go up in response to an underlying condition that’s causing your body to react. This is usually brought on by infections or inflammatory conditions in your body, such as rheumatoid arthritis or juvenile idiopathic arthritis. Acute lymphoblastic leukemia can also cause this type of thrombocytosis.
This may be followed by rare bone marrow disorders including myeloproliferative diseases, polycythemia vera, and essential thrombocythaemia, all of which can cause a chronic form of thrombocytosis.
Myeloproliferative diseases are disorders in which the bone marrow makes too many blood cells, polycythemia vera is a blood cancer involving increased platelets and essential thrombocythaemia is an inherited disorder in which the bone marrow makes too many white blood cells. These three rare disorders can increase your risk of developing other cancers or possibly leukemia.
what is a normal platelet count for a child:
A platelet count measures the number of platelets in your blood. Platelets are cells that help prevent bleeding by stopping or slowing down the flow of blood when you get cut or injured. They also help your blood clot stop bleeding.
The normal range for a platelet count is between 140,000 and 450,000 per microliter of blood (MCL) in people who aren’t having any health problems.
when to worry about high platelet count in a child:
A doctor may test your child’s platelet count if he or she is having problems with bleeding or bruising, if someone in your family has a genetic disorder that can cause abnormal bleeding, or if you have had treatment for leukemia. A doctor might also check the level of platelets in your blood after an organ transplant to make sure there isn’t too much clotting.
in thrombocytosis:
Thrombocytosis is diagnosed by taking a complete medical history and performing a physical examination. If necessary tests are performed including;- CSF protein electrophoresis is indicated in the presence of neurological signs (seizures, headaches), neuroradiological abnormalities (symptoms of spinal cord compression), chilblains, and musculoskeletal pain, bleeding diatheses.
-Rheumatoid Factor (RF) is thought to be a marker of ongoing inflammation associated with autoimmune disease.
-Performed when the differential diagnosis includes essential thrombocythaemia as this may be present as a novel mutation.
-ANA Testing:
antinuclear antibodies are routinely performed in many laboratories as they can aid in the diagnosis of Goodpasture syndrome, systemic lupus erythematosus, and scleroderma which all have overlapping clinical features with APS and because certain rheumatic diseases such as lupus and Sydenham’s chorea should be excluded before starting hydroxychloroquine treatment
-D-dimer levels help to rule out venous thrombosis and may also be elevated in polycythemia vera (increased bleeding tendency)
How to decrease platelet count in a child:
If your child is diagnosed with thrombocytosis, the possible treatments will depend on what caused the disorder. If your child is being treated for leukemia or another type of cancer, then chemotherapy or other treatments may be recommended.
If there isn’t an underlying cause for the increase in platelets, treatment might not be necessary unless there are signs of bleeding or excessive bruising. This is possible if it occurs during childhood when the bones are still growing and have yet to reabsorb old bone tissue.
otherwise simple measures can be taken to decrease platelet count including:-
-pain medications such as acetaminophen (Tylenol) can help ease pain and reduce any fever that could be related to a viral infection such as flu or cold.
-avoiding the use of anti-inflammatory drugs like ibuprofen (Advil) and naproxen (Aleve).
– avoid smoking and drinking excessive alcohol—both can make platelets build up in the blood and increase your risk for serious complications such as heart attack or stroke.
How to decrease platelet count in a child:
The exact cause of the disorder is unknown. There are five types of thrombocytopenia:- primary, secondary, cyclic, reactive, and idiopathic (of no known cause; also called essential). Thrombocytopenia for which no specific cause can be found is defined as idiopathic. Idiopathic thrombocytopenic purpura (ITP) comprises around 80% of cases.
It occurs more frequently in girls than boys. The average age at presentation is between seven and ten years old with a peak incidence at 9 to 12 years old. Hematologic disorders that predispose patients to ITP include autoimmune diseases like systemic lupus erythematosus, other hematologic disorders such as hemolytic anemia, and congenital bleeding disorders.
Secondary thrombocytopenia is the most common form and occurs as a result of other disorders or drugs, such as autoimmune hemolytic anemia; certain medications; infections like mononucleosis; cancer chemotherapy; and autoimmune disorders, such as rheumatic fever (an acute complication of streptococcal infection) and systemic lupus erythematosus.
More than 90% of cases occur in children less than twelve years old. This type is diagnosed by finding abnormal results during blood tests for red blood cells, white blood cells, platelets, or another disease. The underlying illness can cause either low average platelet count (thrombocytopenia), high platelet turnover (thrombocytosis), or a combination of both.
Symptoms can include bleeding like nosebleeds, or vomiting blood (hematemesis), and the stool may contain blood (hematochezia). Other symptoms of ITP may be a decrease in a child’s energy level and an increase in bruising
The initial treatment for thrombocytopenia is to reduce the number of platelets that are circulating in the body by performing steroid pulse therapy. The goal of this therapy is to help restore normal blood counts before starting other treatments.
A course of intravenous immunoglobulin has been used successfully with some children who have more severe forms of thrombocytopenic purpura. However, more studies need to be done on its efficacy and safety.
The goal of steroid therapy is to reduce the number of platelets in the body and increase the number of red blood cells. Children who have undergone this type of treatment can receive normal doses of acetaminophen (Tylenol) for any fever, but they should avoid anti-inflammatory medications such as ibuprofen (Advil), naproxen (Aleve), and aspirin which could further compromise their platelet count.