Kaya Kaan, Cavolli Raif, Telli Alpaslan, Tasoz Refik
Ozel Ulus Hospital, Cardiovascular Surgery, Kazim Karabekir Bulvari, Aslanbey Caddesi, Atakent Sokak, No. 8, Iskitler, Ankara, Turkey.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.01.2009.1503. Epub 2009 Aug 25.
Essential thrombocythaemia (ET) is a rare chronic myeloproliferative disease characterised by persistent thrombocytosis. Cerebral, myocardial and peripheral thrombosis are frequently seen complications, but bleeding and venous thrombosis are more rare. Here, a case of essential thrombocythaemia complicated by cerebral and myocardial thrombosis is presented. The patient's platelet count was 680×10(9)/litre on admission. Electrocardiogram showed a slight ST elevation in leads V1 to V4. A coronary angiography was performed and it revealed a severe stenosis of the left anterior descending artery. The patient had a successful off-pump coronary artery bypass grafting surgery. After the operation the platelet count was 390×10(9)/litre. The patient received hydroxyurea and aspirin treatment preoperatively and continued postoperatively. ET is a rare myeloproliferative disease; its complications are also rare, but the occurrence of two life-threatening complications in the same patient is rarer still. Further investigations are needed to determine the risk stratification for patients with ET undergoing cardiac surgery.
原发性血小板增多症（ET）是一种罕见的慢性骨髓增殖性疾病，其特征为持续性血小板增多。脑、心肌和外周血栓形成是常见的并发症，但出血和静脉血栓形成则较为少见。本文报告一例原发性血小板增多症并发脑和心肌血栓形成的病例。患者入院时血小板计数为680×10⁹/升。心电图显示V1至V4导联ST段轻度抬高。进行了冠状动脉造影，结果显示左前降支严重狭窄。患者成功接受了非体外循环冠状动脉搭桥手术。术后血小板计数为390×10⁹/升。患者术前及术后均接受了羟基脲和阿司匹林治疗。原发性血小板增多症是一种罕见的骨髓增殖性疾病；其并发症也很罕见，但同一患者出现两种危及生命的并发症则更为罕见。需要进一步研究以确定接受心脏手术的原发性血小板增多症患者的风险分层。
