Case, "Occurence, etiology, and clinical significance of
extreme thrombocytosis: a study of 280 cases," The American Journal of Medicine, vol.
Postsplenectomy reactive thrombocytosis may occur in 75-85% of patients, and splenectomy accounts for 19% of extreme thrombocytosis [19, 20].
reported a patient who received a dose of romiplostim within 24 hours prior to splenectomy and subsequently developed extreme thrombocytosis requiring hydroxyurea and ultimately plateletpheresis due to headache, blurred vision, and nausea [23].
In conclusion, there is minimal data to truly assess the temporal relationship between TPO-RA administration and extreme thrombocytosis after splenectomy in patients with ITP.
To consider the characteristics and clinical implication of thrombocytosis and to compare published data, the following arbitrary classification of thrombocytosis has been chosen in current textbooks: mild thrombocytosis, if the platelet count is >500 and <700 X [10.sup.9]/l; moderate thrombocytosis, if the platelet count ranges between >700 and <900 X [10.sup.9]/l; severe thrombocytosis, if the platelet count is >900 X [10.sup.9]/l; and
extreme thrombocytosis, if the platelet count is >1000 X [10.sup.9]/l.
