Differential Diagnosis for High Platelets in a Child

• Single most likely diagnosis
  • Reactive thrombocytosis: This condition is characterized by an elevated platelet count in response to an underlying condition such as infection, inflammation, or trauma. It is the most common cause of thrombocytosis in children and typically resolves once the underlying condition is treated.
• Other Likely diagnoses
  • Iron deficiency anemia: This condition can lead to an increase in platelet production, resulting in thrombocytosis. It is a common condition in children, especially those with poor dietary habits or increased demand for iron.
  • Infection: Certain infections, such as bacterial or viral infections, can stimulate the production of platelets, leading to thrombocytosis.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Leukemia: Although less common, leukemia can present with thrombocytosis, and it is crucial to rule out this diagnosis due to its severe consequences if left untreated.
  • Sickle cell disease: This condition can lead to thrombocytosis due to chronic hemolysis and splenic sequestration.
• Rare diagnoses
  • Essential thrombocythemia: A rare myeloproliferative disorder that can cause thrombocytosis, although it is more common in adults.
  • Myeloproliferative neoplasms: Other rare conditions, such as polycythemia vera or primary myelofibrosis, can also cause thrombocytosis in children, although they are extremely rare in this age group.