Korean J Hematol.  2009 Dec;44(4):298-303. 10.5045/kjh.2009.44.4.298.

Prolonged Extreme Thrombocytosis in a Postsplenectomy Patient with Hereditary Spherocytosis

• Park YM
• Park J
• Jo Y
• Kim SH
• Shin KC
• Won IS
• Sym SJ
• Cho EK
• Shin DB
• Lee JH

• KMID: 2252116
• DOI: http://doi.org/10.5045/kjh.2009.44.4.298

Abstract

We report a case of prolonged extreme reactive thrombocytosis in a post-splenectomy patient with hereditary spherocytosis. A 29-year-old female patient presented with gall stones detected incidentally by abdominal ultrasonography. Her laboratory findings showed hemolytic anemia with spherocytosis on the peripheral blood smear and increased osmotic fragility. She was diagnosed with hereditary spherocytosis and underwent a laparoscopic cholecystectomy and splenectomy. After undergoing surgery, the hemolytic anemia was resolved but thrombocytosis was newly detected. Nineteen months after the splenectomy, the thrombocytosis was still persistent and extremely high. To our knowledge, this is the first report of a prolonged extreme reactive thrombocytosis after a splenectomy in Korea.

Keyword

Reactive thrombocytosis; Postsplenectomy; Hereditary spherocytosis

MeSH Terms

Adult
Anemia, Hemolytic
Cholecystectomy, Laparoscopic
Female
Gallstones
Humans
Korea
Osmotic Fragility
Spherocytosis, Hereditary
Splenectomy
Thrombocytosis

Figure

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  Fig. 1. Peripheral blood smear shows normocytic normochromic anemia with spherocytes which are small hyperchromatic cells without the usual clear area in the center (Wright stain, ×400).

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  Fig. 2. Abdominopelvic computed tomography shows subtle high density in gall bladder suggesting GB stone and splenomegaley of 155 mm.

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  Fig. 3. The platelet count was increased after splenectomy. After the anagrelide therapy, the count was decreased, but after the discontinuation of the anagrelide therapy, it began to increase again. 19 months after having underwent splenectomy, extreme thrombocytosis is persistent.

Reference

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