Background: Essential thrombocythemia (ET) is a myeloproliferative neoplasm with rare incidence, a prevalence of 30/100.000 population. the disorder is characterized by increase of platelet with tendency for thrombosis (micro vascular and macro vascular) and bleeding. the median age at diagnosis is 65 to 70, but can occur at any age. the ratio of male to female is approximately 2:1. Thrombocytosis can occur because of other diseases (reactive thrombocytosis) or without any other causes (primary thrombocytosis / clonal), which requires additional tests to know the cause of thrombocytosis. 

Aims: Case report essential thrombocythemia with deep vein thrombosis and recurrent gangrene pedis.

Methods: Case repot.

Results: A 54-year-old man with blackened of both feet since 4 months ago. The patient complained of stabbing pain than happens intermittently. Furthermore, there was swelling and pain on the right feet since one month ago. This patient had a history of left toe amputation twice due to gangrene; the fifth finger on the left feet two years ago and the first finger on the left feet a year ago. Physical examination found splenomegaly. The laboratory tests found hemoglobin 10 gr/dl, leukocytes 34.080/mm³, thrombocytes 3.032.000/mm³ and giant platelets, multinucleated, and grape-like shapes was found at the peripheral blood smear. Doppler ultrasound found partial DVT on the right leg. Bone marrow examination results: multinucleated megakaryocytes, grouped platelets and cytoplasm area. Test result of JAK2V617F is positive. Final diagnosis: essential thrombocythemia with DVT and recurrent gangrene pedis. Treatment of this patient is anti coagulants (heparin followed by warfarin), anti aggregation (aspilet 80 mg daily) and hydroxyurea 500 mg twice per day howed clinical and laboratory improvement.

Figure 

Conclusions: We reported a 54 years old male with diagnosis essential thrombocythemia with deep vein thrombosis and recurrent gangrene digiti pedis. Patient was medicated with anti coagulant, anti aggregation, and hydroxyurea which gives good outcome. 

« Back to ISTH 2021 Congress

ISTH Congress Abstracts - https://abstracts.isth.org/abstract/essential-thrombocythemia-with-deep-vein-thrombosis-and-recurrent-gangrene-pedis/