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

Abstract

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.

Predictive Factors for Determining the Clinical Severity of Pediatric Scorpion Envenomation Cases in Southeastern Turkey

“…32 Another mechanism involves the effect of hyperglycemia on platelets; this phenomenon was reported for diabetes patients with acute myocardial infarction by Oswald et al 32 Acute myocardial ischemia itself can cause reactive thrombocytosis; this phenomenon has been cited in 2 case reports in the literature. 33 Our study had limitations similar to those of other retrospective studies. Also, we were unable to discover the scorpion species, and information was missing from the medical records.…”

“…32 Another mechanism involves the effect of hyperglycemia on platelets; this phenomenon was reported for diabetes patients with acute myocardial infarction by Oswald et al 32 Acute myocardial ischemia itself can cause reactive thrombocytosis; this phenomenon has been cited in 2 case reports in the literature. 33…”

Could there be a relation between Steven-Johnson syndrome and ST-segment elevation myocardial infarction?

“…Sharma et al in 2019 and Geo et al in 2015 published two separate cases of patients with essential thrombocytosis of platelet level 1095×10 3 /μL and 600×10 3 /μL, respectively, causing hyperviscosity syndrome leading to a thrombus formation resulting in MI 7 8. Meanwhile, Dumrongmongcolgul et al published a case of a patient who developed a MI due to reactive thrombocytosis of platelet count of 966×10 3 /μL 9…”

Reactive thrombocytosis resulting from frequent blood donations as an extremely rare cause of ST Segment Elevation Myocardial Infarction in the case of a 19-year-old male

“…Yet, in another retrospective study comprising 129 patients with the platelet count over 1 mln/uL, Buss et al [12] showed a constant frequency of incidents of thrombosis among patients with myeloproliferative conditions and patients with RT. [1,[13][14][15][16][17]. The phenomenon of reactive thrombocytosis after splenectomy is the one best known so far.…”