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Hi I Am 33 Years Old I Have Platelets Elevating

Posted on Thu, 18 Jun 2020

Question: Hi I am 33 years old I have platelets elevating every year now at 515,000 and SED rate elevating every year at 48 now. My CRP is normal and ferritin is normal. H/H normal, all other labs normal. I am 300 LBS. Dont smoke currently or drink. I have genital herpes. What could this be? Early signs of cancer? Or blood
disorder? History of lung cancer and breast cancer in family, unaware of other cancers.

Follow up: Dr. Shailja Puri (0 minute later)

Hi I am 33 years old I have platelets elevating every year now at 515,000 and SED rate elevating every year at 48 now. My CRP is normal and ferritin is normal. H/H normal, all other labs normal. I am 300 LBS. Dont smoke currently or drink. I have genital herpes. What could this be? Early signs of cancer? Or blood
disorder? History of lung cancer and breast cancer in family, unaware of other cancers.

Answered by Dr. Shailja Puri (25 hours later)

Brief Answer:
Raised ESR and raised platelets can be due to inflammation as well

Detailed Answer:
Hello,
Thanks for posting your query on Ask A Doctor forum.

The sedimentation rate (ESR) is normal up to 20 mm in first hour females.
ESR of 48 mm is high. ESR is raised in inflammatory conditions.

The platelet count of over 5 lakh is mildly increased.

High platelet count along with raised ESR is suggestive of an inflammatory condition.
I'd suggest you get a complete blood count done (CBC) and let me know the results for further interpretation.

These two investigations do not suggest any cancer, however, the underlying cause needs to be found out.

Thanks and take care
Dr. Shailja Puri

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Answered by Dr. Shailja Puri (0 minute later)

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Shailja Puri (2 hours later)

Ok thank you. My CRP was normal 4.2 so I though got inflammation that had to elevated with the other readings to have inflammation in the body. My ferritin level is 51. And my H/H are normal. I’m just concerned cause of the really high SED rate and possibly being the beginning of cancer. What other issues could it possibly be? Could genital herpes cause inflammation? These are my other labs.
WBC 7.5 RBC 4.29 H/H 12.3 and 36.9
Neutrophil 4395. Lymphocytes 2385. ALC 5.4 Monocytes 585 eosinophils 83
Basophils 53. Electroyltes all normal. Bun/creat normal. AST 23 ALT 22. Cholesterol 207. Triglycerides 166 and LDL 124. Could it be heart related?
Thank you

Follow up: Dr. Shailja Puri (0 minute later)

Answered by Dr. Shailja Puri (8 hours later)

Brief Answer:
LDL is mildly increased. Platelet count needs to be monitored regularly.

Detailed Answer:
Hello and welcome again,
Raised ESR with normal CRP suggests a prior inflammatory condition which is has resolved.
ESR usually takes longer to resolve than CRP.
The blood counts are normal.
There is mild increase in LDL, however, this can be resolved with life style modification.
These investigations do not suggest cancer, so there is nothing to worry.
I suggest you to monitor the platelet count on regular basis and peripheral blood smear examination for morphology of platelets.
In case there is constant increase in platelet count, bone marrow aspiration may be required.

Thanks and take care
Dr Shailja Puri

Above answer was peer-reviewed by : Dr. Kampana

Answered by Dr. Shailja Puri (0 minute later)

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Shailja Puri (11 hours later)

Hello again thank you.
Ok I will do that. Lastly, my platelets three years ago was 400,000, then last year 452,000 and now this month 515,000, as well as SED rate going up every year now 48. If not cancer, what else could be the cases of elevated platelets over time and never decreasing? And why a bone marrow aspiration?
Can genital herpes outbreaks cause those 2 to keep elevating? XXXXXXX

Follow up: Dr. Shailja Puri (0 minute later)

Answered by Dr. Shailja Puri (17 minutes later)

Brief Answer:
Steady increase in platelets warrants bone marrow aspiration study.

Detailed Answer:
Hello and welcome again,
The platelet count is increasing over past years so I suggest you to get bone marrow aspiration.
Bone marrow aspiration is required to know the status of platelet progenitors.
This can give a clue to probable cause of increase in platelet count.
Platelets are commonly increased in case of infection, inflammation, iron deficiency and less commonly neoplasia.
Genital herpes is a viral infection.
It can lead to increase in lymphocytes, however, platelet count is not usually affected by herpes infection.
I suggest you to consult a hematologist for bone marrow aspiration study.

Thanks and take care
Dr Shailja Puri

Above answer was peer-reviewed by : Dr. Prasad

Answered by Dr. Shailja Puri (0 minute later)

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Shailja Puri (22 hours later)

Ok I will do that thank you.
So it possibly could be cancer? The bone marrow will show that?

Could the high platelets gradually going on over the last two years possibly just be from gaining so much weight and being obese?

Is the SED rate of 48 concerning? I read SED of 100 means cancer has metastasized, that’s half of what I have now. Could that be possible at all?

Thank you XXXXXXX

Follow up: Dr. Shailja Puri (0 minute later)

Answered by Dr. Shailja Puri (3 hours later)

Brief Answer:
Raised platelets and high ESR do not imply cancer.

Detailed Answer:
Hello and welcome again,

Increased number of platelets and high ESR does not imply cancer.
Kindly, get the bone marrow aspiration and wait for the report.
The lab view does not point towards cancer at this point.

Thanks and take care
Dr. Shailja Puri

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Answered by Dr. Shailja Puri (0 minute later)