A 23-year-old man is brought by helicopter to a major trauma center after a severe motorcycle accident. He has major abdominal trauma, including a ruptured spleen, and is taken to surgery, where his spleen is removed. Two weeks after surgery, his platelet count peaks at 950 *10⁹/L. What is the most likely cause for this high platelet count?

Question

Quizplus · Accepted Answer

After splenectomy, platelet counts usually increase and can remain elevated for several weeks. This is due to the loss of the spleen as a platelet reservoir and the increased release of thrombopoietin from the liver. This is the likely cause of the high platelet count in this case. Reactive thrombocytosis due to trauma or acute blood loss would typically resolve within a few days, whereas essential thrombocythemia is a chronic myeloproliferative disorder that is much less common.

A 23-Year-Old Man Is Brought by Helicopter to a Major