II. Epidemiology

  1. More common in women

III. Symptoms and signs

  1. Common
    1. Headache
    2. Paresthesias
  2. Less common
    1. Thrombotic events
    2. Bleeding events

IV. Differential Diagnosis

  1. Reactive Thrombocytosis
  2. Clonal Thrombocytosis
  3. Chronic myeloproliferative disorder

V. Labs (rule-out differential diagnosis above)

VI. Management

  1. Age Under 60 years
    1. Low risk patients
      1. Consider low dose Aspirin
    2. Intermediate risk patients
      1. Platelet Count <1500 x10^3/uL
        1. Anagrelide
        2. Low dose Aspirin
      2. Platelet Count >1500 x10^3/uL
        1. Anagrelide
    3. High risk patients
      1. Hydroxyurea
      2. Anagrelide
      3. Low dose Aspirin
  2. High risk patients over age 60 years
    1. Low dose Aspirin
    2. Hydroxyurea
  3. Women of child bearing age
    1. Consider low dose Aspirin
    2. Interferon alfa in high risk patients

VII. Complications (low Incidence)

VIII. Prognosis: Factors predictive of poor prognosis

  1. Age over 60 years
  2. Thrombosis history

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