Plasma interleukin-6 and C-reactive protein levels in reactive versus clonal thrombocytosis

Ayalew Tefferi, Tiechin C. Ho, Gregory J. Ahmann, Jerry A. Katzmann, Philip R. Greipp

Research output: Contribution to journalArticle

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Abstract

purpose: Evaluate the discriminatory value of plasma interleukin-6 or C-reactive protein levels in clonal thrombocytosis compared with those in reactive thrombocytosis. patients and methods: A comparative analysis of quantitatively measured laboratory values in a prospectively studied group of consecutive patients. The setting was a tertiary referral center consisting of two hospitals and an outpatient clinic. Plasma interleukin-6 and C-reactive protein levels were measured in 91 consecutive patients with thrombocytosis (platelet count ≥ 600 × 109/L). The cause of thrombocytosis was determined by reviewing the medical histories and follow-up data without knowledge of the corresponding laboratory values. Sixty-four patients had reactive thrombocytosis, 20 had clonal thrombocytosis, and 7 had clonal thrombocytosis plus reactive thrombocytosis. Plasma interleukin-6 was measured by an enzyme-linked immunosorbent assay, and C-reactive protein was measured with rate immunonephelometry. results: Interleukin-6 levels were undetectable in all the patients with clonal thrombocytosis, whereas they were increased in 60% of the patients with reactive thrombocytosis or clonal thrombocytosis plus reactive thrombocytosis. There was a correlation between interleukin-6 and C-reactive protein levels (r = .6), and the median and range values of both levels differed significantly between the clonal thrombocytosis group and the other two groups (P <0.0001). In 81% of the patients with reactive thrombocytosis, levels of either interleukin-6 or C-reactive protein were elevated. There was no correlation between interleukin-6 and C-reactive protein levels and the platelet count. conclusions: An elevated interleukin-6 level is rare in uncomplicated clonal thrombocytosis and suggests reactive thrombocytosis. However, an isolated normal value has little discriminatory value. Measurement of C-reactive protein level may be used as a less expensive surrogate for measurement of interleukin-6. Repeatedly low levels of both interleukin-6 and C-reactive protein are most consistent with clonal thrombocytosis.

Original languageEnglish (US)
Pages (from-to)374-378
Number of pages5
JournalThe American journal of medicine
Volume97
Issue number4
DOIs
StatePublished - 1994

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Thrombocytosis
C-Reactive Protein
Interleukin-6
Platelet Count
Hospital Outpatient Clinics

ASJC Scopus subject areas

  • Nursing(all)

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Plasma interleukin-6 and C-reactive protein levels in reactive versus clonal thrombocytosis. / Tefferi, Ayalew; Ho, Tiechin C.; Ahmann, Gregory J.; Katzmann, Jerry A.; Greipp, Philip R.

In: The American journal of medicine, Vol. 97, No. 4, 1994, p. 374-378.

Research output: Contribution to journalArticle

Tefferi, Ayalew ; Ho, Tiechin C. ; Ahmann, Gregory J. ; Katzmann, Jerry A. ; Greipp, Philip R. / Plasma interleukin-6 and C-reactive protein levels in reactive versus clonal thrombocytosis. In: The American journal of medicine. 1994 ; Vol. 97, No. 4. pp. 374-378.
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abstract = "purpose: Evaluate the discriminatory value of plasma interleukin-6 or C-reactive protein levels in clonal thrombocytosis compared with those in reactive thrombocytosis. patients and methods: A comparative analysis of quantitatively measured laboratory values in a prospectively studied group of consecutive patients. The setting was a tertiary referral center consisting of two hospitals and an outpatient clinic. Plasma interleukin-6 and C-reactive protein levels were measured in 91 consecutive patients with thrombocytosis (platelet count ≥ 600 × 109/L). The cause of thrombocytosis was determined by reviewing the medical histories and follow-up data without knowledge of the corresponding laboratory values. Sixty-four patients had reactive thrombocytosis, 20 had clonal thrombocytosis, and 7 had clonal thrombocytosis plus reactive thrombocytosis. Plasma interleukin-6 was measured by an enzyme-linked immunosorbent assay, and C-reactive protein was measured with rate immunonephelometry. results: Interleukin-6 levels were undetectable in all the patients with clonal thrombocytosis, whereas they were increased in 60{\%} of the patients with reactive thrombocytosis or clonal thrombocytosis plus reactive thrombocytosis. There was a correlation between interleukin-6 and C-reactive protein levels (r = .6), and the median and range values of both levels differed significantly between the clonal thrombocytosis group and the other two groups (P <0.0001). In 81{\%} of the patients with reactive thrombocytosis, levels of either interleukin-6 or C-reactive protein were elevated. There was no correlation between interleukin-6 and C-reactive protein levels and the platelet count. conclusions: An elevated interleukin-6 level is rare in uncomplicated clonal thrombocytosis and suggests reactive thrombocytosis. However, an isolated normal value has little discriminatory value. Measurement of C-reactive protein level may be used as a less expensive surrogate for measurement of interleukin-6. Repeatedly low levels of both interleukin-6 and C-reactive protein are most consistent with clonal thrombocytosis.",
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