What is the relationship between POEMS (Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal gammopathy, and Skin changes) syndrome and thrombocytosis (elevated platelet count)?

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Last updated: May 19, 2025View editorial policy

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From the Research

There is no established connection between poems and thrombocytosis, but a rare condition called POEMS syndrome can sometimes present with thrombocytosis as one of its hematologic manifestations. Thrombocytosis is a medical condition characterized by an abnormally high platelet count in the blood (typically above 450,000 platelets per microliter), which can be either primary (caused by bone marrow disorders) or secondary (reactive to other conditions like inflammation, infection, or iron deficiency) 1. The causes of thrombocytosis can be identified using a new definition, and a retrospective study found that among 1,202 patients with thrombocytosis, 150 (12.5%) had primary and 999 (83.1%) had secondary thrombocytosis 2.

Key Points to Consider

  • Thrombocytosis can occur as a primary event accompanying hematological diseases or as a secondary event 2
  • POEMS syndrome is a paraneoplastic disorder associated with plasma cell dyscrasia that can sometimes present with thrombocytosis as one of its hematologic manifestations
  • Treatment for thrombocytosis depends on the underlying cause and may include aspirin therapy (81-100mg daily) to prevent clotting complications, hydroxyurea for cytoreduction in primary thrombocytosis, or addressing the underlying condition in secondary cases 1
  • If thrombocytosis is related to POEMS syndrome, treatment would target the underlying plasma cell disorder, typically with chemotherapy regimens like lenalidomide plus dexamethasone, or autologous stem cell transplantation in eligible patients

Management Strategies

  • Aspirin therapy (81-100mg daily) is suggested for most patients with essential thrombocythemia to lower thrombosis risk 1
  • Cytoreduction with hydroxyurea can significantly lower the risk of arterial or venous thrombotic events compared with no cytoreductive therapy in patients at higher risk for thrombosis 1
  • Prevention and treatment of thrombotic, vascular, and bleeding complications in myeloproliferative neoplasms require maintenance of hematocrit less than 45% and cytoreductive therapy in patients with a high risk for thrombotic and vascular complications 3

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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