title: Incidental thrombocytosis: Should it concern the anesthesiologist?
abstract: Preoperative thrombocytosis, often detected incidentally in surgical patients and inadvertently overlooked, has important implications for the anesthesiologists. The primary form is a chronic clonal myeloproliferative disorder usually affecting adults while the secondary type is a benign reactive disease commonly found in children. Serious perioperative hemostatic complications are reported in primary thrombocytosis and hence, a detailed preoperative evaluation and initiation of therapy to lower the platelet count (PC) is required before undertaking surgery. Patients with reactive thrombocytosis however, usually have complication-free surgeries, and if there is no prior evidence of hemostatic complications and the reactive cause can be identified, no specific perioperative intervention may be required. A thorough preanesthetic checkup and implementation of basic thrombo-prophylaxis measures in all patients with a raised PC is advocated. We present here our experience with three infants diagnosed with high preoperative PC, presumably due to reactive causes, who underwent uneventful neurosurgeries at our institution.
authors.affiliation: Department of Anaesthesiology and Intensive Care, Govind Ballabh Pant Hospital, Maulana Azad Medical College, New Delhi, India.
authors.forename: Kiranlata
authors.initials: K
authors.lastname: Kiro
authors.affiliation: Department of Anaesthesiology and Intensive Care, Govind Ballabh Pant Hospital, Maulana Azad Medical College, New Delhi, India.
authors.forename: Pragati
authors.initials: P
authors.lastname: Ganjoo
authors.affiliation: Department of Anaesthesiology and Intensive Care, Govind Ballabh Pant Hospital, Maulana Azad Medical College, New Delhi, India.
authors.forename: Deepti
authors.initials: D
authors.lastname: Saigal
authors.affiliation: Department of Anaesthesiology and Intensive Care, Govind Ballabh Pant Hospital, Maulana Azad Medical College, New Delhi, India.
authors.forename: Upendra
authors.initials: U
authors.lastname: Hansda
keywords: Anesthesia; essential thrombocythemia; perioperative complications; reactive thrombocytosis; thrombocytosis