Thrombocytosis and Thrombocytopenia in Treatment-Naïve Rheumatoid Arthritis Patients: A Single-Centre Retrospective Data-Based Study From Pakistan

Background and objective This study aims to investigate thrombocytosis and thrombocytopenia in treatment-naïve rheumatoid arthritis (RA) patients, addressing the lack of data on their prevalence and clinical significance. By focusing on untreated patients, this study seeks to clarify the disease's natural course without confounding factors from prior therapies. The research is particularly important in the Pakistani context, where regional variations in RA presentation are underexplored. Findings are expected to enhance understanding of these hematological changes, ultimately guiding improved clinical management strategies for RA. Methods The present retrospective data-based study was conducted at the Department of Medicine & Allied Health Sciences, Azra Naheed Medical College, Superior University, Lahore, Pakistan. The 2010 American College of Rheumatology (ACR) diagnostic criteria were used to define RA. Thrombocytosis was defined as a platelet count greater than 400×10⁹/L. Thrombocytopenia was defined as a platelet count less than 150×10⁹/L. The Disease Activity Score in 28 joints (DAS-28 score) was used to categorize the disease severity of RA. Retrospective data were collected from the medical records of 165 patients with RA. Records from January 2023 to December 2023 were included. The assessment included demographic information, rheumatoid factor status, anti-CCP antibody status, disease severity measured by the DAS-28 score, and complete blood count (CBC) results, such as hemoglobin, white blood cell (WBC) count, and platelet count. Data entry and analysis were conducted using IBM SPSS Statistics software, version 23 (IBM Corp., Armonk, NY). Results The mean age of the patients was 42.5±13.6 years, with 25 (15.2%) male and 140 (84.8%) female patients. The RA factor (RAF) was positive in 128 (77.6%) and the anti-CCP antibody in 102 (61.8%). The mean DAS-28 score was 4.5±1.4, with 113 (68.5%) patients having mild-to-moderate disease and 52 (31.5%) patients having severe disease. Mean hemoglobin, WBC, and platelet counts were 12.0±1.4 g/dl, 9.0±2.7 ×10⁹/L, and 352.6±110.4 ×10⁹/L, respectively. Thrombocytosis was seen in 52 (31.5%) patients, while thrombocytopenia was seen in 11 (6.7%). Conclusion Thrombocytosis was seen in almost one-third of RA patients, having a significant association with age, the RAF factor positivity, and anti-CCP antibody negativity but not with gender and disease severity. Thrombocytopenia was relatively uncommon.