Etiology and incidence of thrombotic and hemorrhagic disorders in Thai patients with extreme thrombocytosis.

A retrospective study of 126 patients with extreme thrombocytosis (defined as a platelet count > or = 1,000 x 10(9)/L) was performed during a five-year period (June 1994-June 1999). The aim of this study was to determine the etiology and to evaluate the clinical consequences of extreme thrombocytosis. Seventy patients (55.5%) had reactive thrombocytosis (RT) with an age range of 43 +/- 2.2 years, 56 (44.5%) had chronic myeloproliferative disorders (MPD) with an age range of 53 +/- 2.4 years. Underlying causes of RT were malignancy (25/70 or 35.7%), infection (16/70 or 22.9%), postsplenectomized beta-thalassemia/Hb E (11/70 or 15.7%), inflammation (12/70 or 17.1%), iron deficiency anemia (6/70 or 8.6%). Duration post splenectomy in our beta-thalassemia/Hb E patients ranged from 4 months to 21 years, with a median of 10 years. Subtypes of our MPD cases were chronic myeloid leukemia (30/56 or 53.6%), essential thrombocytosis (18/56 or 32.1%), polycythemia vera (4/56 or 7.1%), agnogenic myeloid metaplasia (3/56 or 5.4%) and unclassified MPD (1/56 or 1.8%). Bleeding and thrombotic tendency were respectively noted in 7 (12.5%) and 2 (3.6%) of MPD patients. Two patients of the MPD group (3.6%) experienced both bleeding and thrombotic episodes. One patient (1.4%) of the RT group developed vasculitis-associated thrombosis. However, none of the patients in the RT group had bleeding complications. Extreme thrombocytosis was not a rare condition in a university hospital population, and bleeding and/or thrombotic complication was more common in the MPD group.

Hematological parameters, ferritin and vitamin B12 in vegetarians.

Hematological parameters and serum ferritin were compared between 179 vegetarians and 58 control subjects using Hematology analyzer H3 and microparticle enzyme immunoassay, respectively. Serum Vitamin B12 was also compared between 68 vegetarians and 30 control subjects using microparticle enzyme immunoassay. It was found that hemoglobin, hematocrit, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, white blood cells, neutrophils, serum ferritin and serum vitamin B12 in vegetarian were significantly lower than control subjects (P < 0.05). In addition, red cell distribution width and lymphocytes in vegetarians were significantly higher than control subjects (P < 0.05). There were 34 cases of iron deficiency in 179 vegetarians (19.%) which can be classified to iron depletion (4 cases), iron deficient erythropoiesis (12 cases) and iron deficiency anemia (18 cases). Vitamin B12 deficiency was found in 27 cases of 68 vegetarians (40%).

Control cells for both electrical impedance and light scattering automated hematological analyzers: preparation from normal and thalassemic blood samples.

The study on quality control of automated blood cell analyzers, Technicon H*1 and Coulter MAXM by using three separately self-prepared control cells was extensively investigated. The three parts of control cells are pseudo-leukocyte and fixed platelets, which are fixed by glutaraldehyde, and control red cells from normal and thalassemic patients preserved and anticoagulated in CPD or CPDA-1. The Technicon H*1 system was based on the principle of light scattering but the Coulter MAXM was based on the principle of electrical impedance for cell counting and measurement. The self-prepared control cells can be satisfactorily utilized as control for each system with statistically significant difference (p < 0.05) for both systems. The expired dates for control cells are different in both systems and should be determined for each system specifically. The control red cells prepared from thalassemic patients were quite satisfactorily useful as an abnormal control for both systems during this study.