A Rare Case of Triple-Negative Essential Thrombocythemia in a Young Postsplenectomy Patient: A Diagnostic Challenge

The distinction between primary and reactive thrombocytosis by bone marrow histology is very important. Reactive thrombocytosis, the most common cause of thrombocytosis, can be expected in postsplenectomy states; however, close hematological evaluation of prolonged thrombocytosis is essential to ide...

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Bibliographic Details
Published in:Case reports in hematology 2018-01, Vol.2018 (2018), p.1-5
Main Authors: Idowu, Modupe, Yan, Melissa, Strati, Paolo, Akcan, Tugce
Format: Article
Language:English
Subjects:
Abdomen
Blood clot
Blood platelets
Bone marrow
Cardiac arrhythmia
Case Report
Case reports
Hemoglobin
Hospitals
Medical imaging
Medical prognosis
Mutation
Spleen
Surgeons
Thrombosis
Trauma
Tumors
Veins & arteries
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Summary:The distinction between primary and reactive thrombocytosis by bone marrow histology is very important. Reactive thrombocytosis, the most common cause of thrombocytosis, can be expected in postsplenectomy states; however, close hematological evaluation of prolonged thrombocytosis is essential to identify patients who may have an underlying myeloproliferative neoplasm. We report a 37-year-old woman who was found to have portal, mesenteric, and splenic vein thrombosis with thrombocytosis, two months after she had a splenectomy for spontaneous splenic rupture. Other reactive conditions and myeloproliferative neoplasms (MPN) were excluded, and subsequently, the diagnosis of triple-negative essential thrombocythemia (ET) was established by bone marrow histology. This case of primary thrombocythemia following splenectomy in a young patient illustrates some of the diagnostic difficulties associated with postsplenectomy thrombocytosis. Continuing reports of anecdotal experiences in managing similar complex scenarios is essential and remains the only reference for clinicians facing these rare conditions.
ISSN:2090-6560
2090-6579
DOI:10.1155/2018/9079462