Secondary Thrombocytosis Treatment & Management

Updated: Aug 10, 2022
  • Author: Devapiran Jaishankar, MBBS; Chief Editor: Srikanth Nagalla, MD, MS, FACP  more...
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Medical Care

The primary treatment of secondary thrombocytosis (reactive thrombocytosis) should address the underlying cause of the thrombocytosis. For example, iron supplementation may normalize platelet counts in patients with thrombocytosis secondary to inflammatory bowel disease. [26]

In general, no treatment is indicated to directly reduce the platelet count. [27]  However, for patients with platelet counts in excess of 1,000,000/μL, aspirin 65 mg daily may be considered to minimize the rare development of stroke or thrombosis. [28]  A case report describes effective use of plateletpheresis for treatment of an internal carotid artery thrombus resulting in a right middle cerebral artery stroke, in a patient with previously undiagnosed reactive thrombocytosis (platelet count of 1,014,000/μL) secondary to iron deficiency anemia. [29]


Long-Term Monitoring

In patients with secondary thrombocytosis (reactive thrombocytosis) for whom the causal comorbid condition has not been identified, maintain complete, careful outpatient monitoring with physical examination and routine laboratory tests to exclude the development of an occult disorder (eg, malignancy).