Acute splenic infarction presenting as an unusual manifestation of essential thrombocythaemia with normal platelet count

What is it about?

Essential thrombocythemia (ET) is characterised by elevated platelet count by a clonal stem cell disorder of megakaryocytes. Although thrombosis is a common complication of ET, splenic infarction (SI) is extremely rare. Here we present the case of a 31-year-old Japanese man who presented with sudden-onset severe pain at the left hypochondrium on the day before admission. Enhanced abdominal computed tomography revealed SI. The laboratory test results revealed a normal platelet count (43.9 ? 104/?L). Subsequently, the patient was diagnosed with ET because the platelet count gradually increased to 50.0 ? 104/?L, and the JAK2 V617F mutation was identified. Accordingly, low-dose aspirin was initiated, and no thrombotic episode occurred. Nevertheless, 6-months post-discharge, the platelet count gradually increased to >65.0 ? 104/?L, and anagrelide was initiated. This case demonstrates an unusual complication of acute SI due to ET under the rare situation of the normal platelet count.

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