Decoding & Exploring the Distribution and Etiology of Thrombocytosis in a Tertiary Care Setting

Abstract

Background: Thrombocytosis, defined as a platelet count above 4.5 × 10⁵ cells/μL, is frequently detected as an incidental finding in routine hematological assessments. Such discoveries can precipitate unnecessary investigations and specialist referrals, generating avoidable clinical concern.
Aim: To examine the occurrence, distribution, and underlying etiologies of thrombocytosis among adult patients with varied clinical presentations.

Methods: A cross-sectional observational study was conducted at Saveetha Medical College and Hospital from January to March 2024. Adult patients exhibiting platelet counts beyond the diagnostic threshold were enrolled. Demographic details, clinical diagnoses, platelet counts, total leukocyte count (TLC), absolute neutrophil count, neutrophil–lymphocyte ratio (NLR), hemoglobin concentration, and C-reactive protein (CRP) levels were documented in a structured database. Statistical correlations were analyzed using Pearson’s coefficient in SPSS version 26.0.

Results: Of 100 patients evaluated (platelet range: 450 × 10³ to 850 × 10³ cells/μL), 2.0% were diagnosed with primary thrombocytosis, while 98.0% exhibited reactive causes. Significant associations were observed with absolute neutrophil count (p = 0.013) and NLR (p = 0.029).

Conclusion: Elevated platelet counts carry clinical significance that extends beyond a laboratory anomaly, reflecting diverse pathological processes. Secondary thrombocytosis remains the predominant form and should be excluded prior to exploring primary etiologies. Judicious interpretation with careful clinical correlation is essential to prevent misdirected diagnostic efforts.