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Introduction <p>We describe the case of a 39-year-old woman who presented with extreme reactive thrombocytosis as a prominent and unusual feature in the context of anti-neutrophil cytoplasmic antibody (myeloperoxidase, MPO)-associated vasculitis. To our knowledge, this is the first reported case in an adult patient where marked thrombocytosis was part of the initial presentation of ANCA-associated vasculitis.</p> Case Presentation <p>The patient presented with a two-month history of constitutional symptoms and polyarticular pain. Laboratory evaluation revealed extreme thrombocytosis, impaired renal function, and positive MPO-ANCA. Renal biopsy demonstrated rapidly progressive pauci-immune crescentic glomerulonephritis consistent with MPA. Based on these findings, a diagnosis of ANCA-associated vasculitis was established. Treatment with high-dose corticosteroids and intravenous cyclophosphamide led to clinical improvement, including resolution of thrombocytosis and recovery of renal function.</p> Conclusions <p>Although the clinical features of ANCA-associated vasculitis were typical, the presence of extreme thrombocytosis may indicate a heightened inflammatory response and deserves careful evaluation. Early recognition and prompt treatment are essential to prevent irreversible organ damage and other complications.</p>

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Extreme thrombocytosis and ANCA-associated vasculitis in an adult patient: a case report

  • 期刊论文

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  • 发表日期：

    2025年11月13日

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  • Andrés Hormaza-Jaramillo,
  • Maria J. Varela,
  • Daniela Peñaloza Gonzalez,
  • Sara Alejandra Benavides-Ibarra,
  • Carlos Jimenez,
  • David Aguirre-Valencia

摘要

Introduction

We describe the case of a 39-year-old woman who presented with extreme reactive thrombocytosis as a prominent and unusual feature in the context of anti-neutrophil cytoplasmic antibody (myeloperoxidase, MPO)-associated vasculitis. To our knowledge, this is the first reported case in an adult patient where marked thrombocytosis was part of the initial presentation of ANCA-associated vasculitis.

Case Presentation

The patient presented with a two-month history of constitutional symptoms and polyarticular pain. Laboratory evaluation revealed extreme thrombocytosis, impaired renal function, and positive MPO-ANCA. Renal biopsy demonstrated rapidly progressive pauci-immune crescentic glomerulonephritis consistent with MPA. Based on these findings, a diagnosis of ANCA-associated vasculitis was established. Treatment with high-dose corticosteroids and intravenous cyclophosphamide led to clinical improvement, including resolution of thrombocytosis and recovery of renal function.

Conclusions

Although the clinical features of ANCA-associated vasculitis were typical, the presence of extreme thrombocytosis may indicate a heightened inflammatory response and deserves careful evaluation. Early recognition and prompt treatment are essential to prevent irreversible organ damage and other complications.