Erythromelalgic, thrombotic and haemorrhagic manifestations of thrombocythaemia.

OBJECTIVES

In order to document a relationship between platelet counts and clinical complication of thrombosis or bleeding in patients with myeloproliferative thrombocythaemia, 200 consecutive published cases of thrombocythaemia were reviewed for thrombotic or haemorrhagic manifestations and haematological findings at the time of the thrombohaemorrhagic complication.

METHODS

Cases selected from the literature included all those complying with the diagnosis of thrombocythaemia as mandated by the Polycythemia Vera Study Group. One hundred consecutive cases of thrombocythaemia complicated by bleedings and one hundred consecutive cases of thrombocythaemia complicated by thrombosis were reviewed for clinical manifestations and haematological findings.

RESULTS

In the reviewed cases of thrombocythaemia haemorrhagic complications (platelet count 2016 +/- 1070 x 10(9)/1) occurred at significantly (p < 0.001) higher degrees of thrombocytosis than thrombotic complications (platelet count 1110 +/- 477 x 10(9)/1).

CONCLUSIONS

In the reviewed cases of thrombocythaemia arterial complications, especially erythromelalgia, can already be documented at platelet counts in excess of 400 x 10(9)/1, whereas bleeding complications usually occur at significantly higher degrees of thrombocytosis (> 1000 x 10(9)/1).