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Extreme Reactive Thrombocytosis Post-Splenectomy in 16 Years Old Boy

Thrombocytosis is a common occurrence in childhood. The most common causes of thrombocytosis are infection, trauma, surgery, and malignancy. Splenectomy may cause reactive thrombocytosis, which affects approximately 75-80% of patients and is associated with an increased risk of thrombotic and hemorrhagic complications. The appearance of thrombocytosis must be diagnosed in order to determine the treatment and prognosis. Antiplatelet agents, cytoreductive therapy, and/or therapeutic apheresis can be used to accomplish this. We reported a 16-year-old male who developed extreme reactive thrombocytosis following splenectomy. He was admitted to the hospital with a grade IV spleen rupture as a result of blunt abdominal trauma and underwent total splenectomy. After splenectomy, his platelet count was 229x109/L and increased to 1154x109/L on the ninth postoperative day. He stated that he was suffering from a fever, headache, fatigue, and abdominal pain. Therefore, he was referred to a consultant pediatric haemato-oncology specialist for thrombocytosis management and was diagnosed with extreme reactive thrombocytosis. Cytoreductive agents such as hydroxyurea were used to treat him. His platelet count decreased to less than 400x109/L after 37 days of treatment. At 1-year follow-up, his complete blood count remains normal. He has been asymptomatic. We concluded that splenectomy may lead to extreme thrombocytosis, resulting in thrombotic and hemorrhagic complications. Thus, physicians should clinically monitor patients to ensure prompt diagnosis and appropriate treatment, as well as to prevent thrombosis and hemorrhage complications.