Internal Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Pathology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India.
BMJ Case Rep. 2021 Sep 20;14(9):e245267. doi: 10.1136/bcr-2021-245267.
A 63-year-old diabetic woman presented to the outpatient clinic with a 1-week history of abdominal pain. On complete evaluation, she was diagnosed to have essential thrombocythemia. Abdominal imaging revealed portal vein thrombosis with a large splenic infarct. The patient was started on anticoagulant, antiplatelet and cytoreductive therapy. In view of persistent high platelet count, plasma apheresis was done, following which the patient's platelet counts were reduced. Essential thrombocythemia has a high rate of complications, resulting in significant morbidity and mortality. Few cases of this disease and its treatment have been described in the literature, especially pertaining to the Indian scenario. Further studies are needed to establish a multidisciplinary algorithm for its diagnosis and to elucidate the guidelines for the successful treatment of the condition.
一位 63 岁的糖尿病女性因腹痛就诊于门诊。经全面评估，她被诊断为原发性血小板增多症。腹部影像学显示门静脉血栓形成伴巨大脾梗死。患者开始接受抗凝、抗血小板和细胞减少治疗。鉴于血小板计数持续升高，进行了血浆置换，此后患者的血小板计数降低。原发性血小板增多症并发症发生率高，导致发病率和死亡率显著增加。该疾病及其治疗方法在文献中鲜有报道，特别是在印度的情况。需要进一步研究以建立其诊断的多学科算法，并阐明成功治疗该疾病的指南。
