Reactive Thrombocytosis Associated with Acute Myocardial Infarction following STEMI with Percutaneous Coronary Intervention

The etiology of thrombocytosis can be classified into reactive and essential forms. The rate of thromboembolic events is higher in essential thrombocytosis, and these events include strokes, transient ischemic attacks, retinal artery or retinal vein occlusions, digital ischemia, and acute coronary s...

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Main Authors: Nat Dumrongmongcolgul, Charoen Mankongpaisarnrung, Grerk Sutamtewagul, Nattamol Hosiriluck, Timothy Chen, Alexander Trujillo, Nicholas Dcunha, Kenneth Nugent, Leigh Ann Jenkins
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:Case Reports in Cardiology
Online Access:http://dx.doi.org/10.1155/2013/707438
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author Nat Dumrongmongcolgul
Charoen Mankongpaisarnrung
Grerk Sutamtewagul
Nattamol Hosiriluck
Timothy Chen
Alexander Trujillo
Nicholas Dcunha
Kenneth Nugent
Leigh Ann Jenkins
author_facet Nat Dumrongmongcolgul
Charoen Mankongpaisarnrung
Grerk Sutamtewagul
Nattamol Hosiriluck
Timothy Chen
Alexander Trujillo
Nicholas Dcunha
Kenneth Nugent
Leigh Ann Jenkins
author_sort Nat Dumrongmongcolgul
collection DOAJ
description The etiology of thrombocytosis can be classified into reactive and essential forms. The rate of thromboembolic events is higher in essential thrombocytosis, and these events include strokes, transient ischemic attacks, retinal artery or retinal vein occlusions, digital ischemia, and acute coronary syndrome. In a study of 732 medical and surgical patients with thrombocytosis, 88% had reactive thrombocytosis. Patients with reactive thrombocytosis do not require cytoreductive medications or antiplatelet treatment. We report a healthy 40-year-old man without any medical problems who developed a new episode of myocardial infarction associated with thrombocytosis after an episode of myocardial infarction followed by percutaneous coronary intervention. He had thrombocytosis, and his platelet function test did not reveal adequate inhibition. To treat his acute coronary syndrome, therapeutic enoxaparin was added, and clopidrogel was substituted with ticagrelor. We decided to start hydroxyurea to reduce platelets counts. Enoxaparin and hydroxyurea were discontinued when platelet count returned to baseline. JAK-2 and BCR/ABL mutations were negative. This case report highlights a clinical dilemma (reactive thrombocytosis), which is challenging in terms of management and pathophysiology.
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spelling doaj-art-d3e9bbc4eea7452ea664e3ee69f138252025-08-20T02:19:45ZengWileyCase Reports in Cardiology2090-64042090-64122013-01-01201310.1155/2013/707438707438Reactive Thrombocytosis Associated with Acute Myocardial Infarction following STEMI with Percutaneous Coronary InterventionNat Dumrongmongcolgul0Charoen Mankongpaisarnrung1Grerk Sutamtewagul2Nattamol Hosiriluck3Timothy Chen4Alexander Trujillo5Nicholas Dcunha6Kenneth Nugent7Leigh Ann Jenkins8Department of Internal Medicine, Texas Tech University Health Sciences Center, 3601 4th Street, Indiana Avenue, Lubbock, TX 79430, USADepartment of Internal Medicine, Texas Tech University Health Sciences Center, 3601 4th Street, Indiana Avenue, Lubbock, TX 79430, USADepartment of Internal Medicine, Texas Tech University Health Sciences Center, 3601 4th Street, Indiana Avenue, Lubbock, TX 79430, USADepartment of Internal Medicine, Texas Tech University Health Sciences Center, 3601 4th Street, Indiana Avenue, Lubbock, TX 79430, USADepartment of Internal Medicine, Texas Tech University Health Sciences Center, 3601 4th Street, Indiana Avenue, Lubbock, TX 79430, USADepartment of Internal Medicine, Texas Tech University Health Sciences Center, 3601 4th Street, Indiana Avenue, Lubbock, TX 79430, USADepartment of Internal Medicine, Texas Tech University Health Sciences Center, 3601 4th Street, Indiana Avenue, Lubbock, TX 79430, USADepartment of Internal Medicine, Texas Tech University Health Sciences Center, 3601 4th Street, Indiana Avenue, Lubbock, TX 79430, USADepartment of Internal Medicine, Texas Tech University Health Sciences Center, 3601 4th Street, Indiana Avenue, Lubbock, TX 79430, USAThe etiology of thrombocytosis can be classified into reactive and essential forms. The rate of thromboembolic events is higher in essential thrombocytosis, and these events include strokes, transient ischemic attacks, retinal artery or retinal vein occlusions, digital ischemia, and acute coronary syndrome. In a study of 732 medical and surgical patients with thrombocytosis, 88% had reactive thrombocytosis. Patients with reactive thrombocytosis do not require cytoreductive medications or antiplatelet treatment. We report a healthy 40-year-old man without any medical problems who developed a new episode of myocardial infarction associated with thrombocytosis after an episode of myocardial infarction followed by percutaneous coronary intervention. He had thrombocytosis, and his platelet function test did not reveal adequate inhibition. To treat his acute coronary syndrome, therapeutic enoxaparin was added, and clopidrogel was substituted with ticagrelor. We decided to start hydroxyurea to reduce platelets counts. Enoxaparin and hydroxyurea were discontinued when platelet count returned to baseline. JAK-2 and BCR/ABL mutations were negative. This case report highlights a clinical dilemma (reactive thrombocytosis), which is challenging in terms of management and pathophysiology.http://dx.doi.org/10.1155/2013/707438
spellingShingle Nat Dumrongmongcolgul
Charoen Mankongpaisarnrung
Grerk Sutamtewagul
Nattamol Hosiriluck
Timothy Chen
Alexander Trujillo
Nicholas Dcunha
Kenneth Nugent
Leigh Ann Jenkins
Reactive Thrombocytosis Associated with Acute Myocardial Infarction following STEMI with Percutaneous Coronary Intervention
Case Reports in Cardiology
title Reactive Thrombocytosis Associated with Acute Myocardial Infarction following STEMI with Percutaneous Coronary Intervention
title_full Reactive Thrombocytosis Associated with Acute Myocardial Infarction following STEMI with Percutaneous Coronary Intervention
title_fullStr Reactive Thrombocytosis Associated with Acute Myocardial Infarction following STEMI with Percutaneous Coronary Intervention
title_full_unstemmed Reactive Thrombocytosis Associated with Acute Myocardial Infarction following STEMI with Percutaneous Coronary Intervention
title_short Reactive Thrombocytosis Associated with Acute Myocardial Infarction following STEMI with Percutaneous Coronary Intervention
title_sort reactive thrombocytosis associated with acute myocardial infarction following stemi with percutaneous coronary intervention
url http://dx.doi.org/10.1155/2013/707438
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