(See also Overview of Myeloproliferative Neoplasms Overview of Myeloproliferative Neoplasms Myeloproliferative neoplasms are clonal proliferations of bone marrow stem cells, which can manifest as an increased number of platelets, red blood cells (RBCs), or white blood cells (WBCs)... read more .)
Some causes of reactive thrombocytosis include
Chronic inflammatory disorders (eg, rheumatoid arthritis Rheumatoid Arthritis (RA) Rheumatoid arthritis is a chronic systemic autoimmune disease that primarily involves the joints. Rheumatoid arthritis causes damage mediated by cytokines, chemokines, and metalloproteases.... read more
, inflammatory bowel disease Overview of Inflammatory Bowel Disease Inflammatory bowel disease (IBD), which includes Crohn disease and ulcerative colitis, is a relapsing and remitting condition characterized by chronic inflammation at various sites in the gastrointestinal... read more , tuberculosis Tuberculosis (TB) Tuberculosis is a chronic, progressive mycobacterial infection, often with an asymptomatic latent period following initial infection. Tuberculosis most commonly affects the lungs. Symptoms include... read more 
, sarcoidosis Sarcoidosis Sarcoidosis is an inflammatory disorder resulting in noncaseating granulomas in one or more organs and tissues; etiology is unknown. The lungs and lymphatic system are most often affected, but... read more 
, granulomatosis with polyangiitis Granulomatosis with Polyangiitis (GPA) Granulomatosis with polyangiitis is characterized by necrotizing granulomatous inflammation, small- and medium-sized vessel vasculitis, and focal necrotizing glomerulonephritis, often with crescent... read more 
)Acute infection
Hemorrhage
Hemolysis
Cancer
Splenectomy or hyposplenism
There are also congenital familial thrombocytoses such as those due to thrombopoietin and thrombopoietin receptor gene mutations. For thrombocytosis that is not secondary to another disorder, see Essential Thrombocythemia Essential Thrombocythemia Essential thrombocythemia (ET) is a myeloproliferative neoplasm characterized by an increased platelet count, megakaryocytic hyperplasia, and a hemorrhagic or microvascular vasospastic tendency... read more .
Platelet function is usually normal. Unlike in essential thrombocythemia Essential Thrombocythemia Essential thrombocythemia (ET) is a myeloproliferative neoplasm characterized by an increased platelet count, megakaryocytic hyperplasia, and a hemorrhagic or microvascular vasospastic tendency... read more , reactive thrombocytosis does not increase the risk of thrombotic or hemorrhagic complications unless patients have severe arterial disease or prolonged immobility.
With secondary thrombocytosis, the platelet count is usually < 1,000,000/mcL (< 1000 × 109/L), and the cause may be obvious from the history and physical examination (perhaps with confirmatory testing). Complete blood count and peripheral blood smear findings may help suggest iron deficiency or hemolysis.
If a cause of secondary thrombocythemia is not obvious, patients should be evaluated for a myeloproliferative neoplasm Overview of Myeloproliferative Neoplasms Myeloproliferative neoplasms are clonal proliferations of bone marrow stem cells, which can manifest as an increased number of platelets, red blood cells (RBCs), or white blood cells (WBCs)... read more . Such evaluation may include testing for myeloproliferative neoplasm driver mutations Diagnosis Essential thrombocythemia (ET) is a myeloproliferative neoplasm characterized by an increased platelet count, megakaryocytic hyperplasia, and a hemorrhagic or microvascular vasospastic tendency... read more , cytogenetic studies, including Philadelphia chromosome or BCR-ABL assay, and possibly bone marrow examination, especially in patients with anemia, macrocytosis, leukopenia, and/or hepatosplenomegaly.
Treatment of the underlying disorder usually returns the platelet count to normal.
