HNY Policy and Pathway Repository - North Yorkshire

Platelets >450 ×10⁹/L

Platelets >1000 ×10⁹/L

• Recent arterial or venous thromboembolism
• Neurological symptoms
• Abnormal bleeding

Work‑up:

• Clinical correlation and review for symptoms of underlying disorders (see box below) such as infection, inflammation, malignancy
• CRP/ESR – Occult inflammation
• Ferritin

Causes 

• Iron Deficiency Anaemia
• Malignancies especially the LEGO cancers (lung, endometrium, gastric and oesophageal)
• Inflammation
• Infection
• Post‑Splenectomy and Hyposplenism (e.g. Coeliac Disease)
• Myeloproliferative Disorders
• Post‑Operatively

Refer urgently (suspected cancer) to haematology:

• Platelets >1000 ×10⁹/L
  • Recent arterial or venous thromboembolism
  • Neurological symptoms
  • Abnormal bleeding

Refer routinely to haematology:

• Platelets >450 ×10⁹/L
  • Repeat FBC in 6 weeks and look for causes
  • If persistent >450 ×10⁹/L and no obvious cause refer routinely to Haematology

• Harrogate and District