Dear Doctor Column, December 27, 2004
No Known Cause for Blood Disorder
Question:
I have just been diagnosed with thrombocythemia. Please tell me more about it and what I can expect in how I feel. What types of treatment are available and the prognosis? I understand it's rare. Is it contagious?
Answer:
Thrombocythemia is a disorder in which excess platelets, which make blood clot, are produced in the bone marrow, leading to abnormal blood clotting or bleeding. There is no known case for the disease. Thrombocythemia is rare, affecting about 2 to 3 of 100,000 people, usually occurring in people older than age 50 years and more frequently in women. It is not contagious.
The following are the most common symptoms of thrombocythemia, which are due to the blockage of blood vessels and may include:
- tingling and other abnormal sensations in the hands and feet (paresthesias)
- cold fingertips
- bruising easily
- bleeding from the nose, gums, or in the digestive tract
- bloody stools
- headaches, weakness, and dizziness
- enlarged lymph nodes
The symptoms of thrombocythemia may resemble other blood disorders or medical problems. A doctor makes a diagnosis of thrombocythemia on the basis of the person's symptoms and after finding increased platelets during routine screening of the blood. In thrombocythemia, the platelet count is usually 2 to 4 times higher than normal. A bone marrow biopsy also may be necessary.
Specific treatment for thrombocythemia is determined by your physician based on your age, overall health, medical history, and other risk factors. The disease may require treatment with a drug that decreases platelet production, such as hydroxyurea, interferon-alpha, or anagrelide. Aspirin may help decrease clotting by making the platelets less sticky. Drug treatment may be combined or replaced by plateletpheresis, a procedure to remove extra platelets from the blood. In this procedure, which is reserved for emergency situations, blood is withdrawn, platelets are removed from it, and the platelet-depleted blood is put back in the person.
The prognosis of the disease varies from prolonged periods without complications in some people to fatalities from complications related to hemorrhage and thrombosis (stroke, heart attack, or blood clots in extremities) in others.