Blood Res 2018; 53(3): 233-239  https://doi.org/10.5045/br.2018.53.3.233
A cross-sectional retrospective study to analyze the underlying causes and clinical characteristics of children with reactive thrombocytosis at a Korean tertiary medical center
Juhee Shin, Dong Hyun Lee, Nani Jung, Hee Joung Choi, Ye Jee Shim
Department of Pediatrics, Keimyung University School of Medicine and Dongsan Medical Center, Daegu, Korea
Correspondence to: Ye Jee Shim, M.D., Ph.D.Department of Pediatrics, Keimyung University School of Medicine, Dongsan Medical Center, Dalseong-ro 56, Jung-gu, Daegu 41931, Korea E-mail: yejeeshim@dsmc.or.kr
Received: April 2, 2018; Revised: June 4, 2018; Accepted: June 26, 2018; Published online: September 30, 2018.
© The Korean Journal of Hematology. All rights reserved.

cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background
Reactive thrombocytosis (RT) is a common condition among children, although no studies have examined the etiology or clinical characteristics of RT among Korean children.
Methods
This retrospective study evaluated children with RT at a single Korean tertiary center during a 10-year period.
Results
RT accounted for 13.5% of children who were admitted to the pediatric ward (4,113/30,355): mild RT, 82.7%; moderate RT, 14.1%; severe RT, 1.1%; and extreme RT, 2.1%. There was a negative correlation between platelet count and Hb level (P=0.008). There were positive correlations between platelet count and WBC (P=0.001), erythrocyte sedimentation rate (ESR) (P=0.007), and admission duration (P=0.006). The most common cause of RT was infection and the second most common was Kawasaki disease (KD). The highest proportion of lower respiratory tract infection was observed in extreme RT (P<0.001). The proportion of KD was highest in extreme RT (P<0.001) and in children aged 1‒7.9 years (P<0.001). The proportion of refractory KD was highest in extreme RT (P=0.005). In cases of KD, there was a positive correlation between platelet count and fever duration (P=0.006). Non-KD autoimmune inflammation was only observed in mild/moderate RT, and its proportion was highest in children aged 8‒18 years (P<0.001).
Conclusion
In children, more severe RT was associated with lower Hb, increased WBC, ESR, and prolonged admission. With respiratory infection or KD, extreme RT was associated with more severe disease course.
Keywords: Reactive thrombocytosis, Extreme thrombocytosis, Children, Etiology, Kawasaki disease


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