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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Main Authors: T. Akcan, P. Strati, M. Yan, M. Idowu
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Case Reports in Hematology
Online Access:http://dx.doi.org/10.1155/2018/9079462
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author T. Akcan
P. Strati
M. Yan
M. Idowu
author_facet T. Akcan
P. Strati
M. Yan
M. Idowu
author_sort T. Akcan
collection DOAJ
description 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.
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spelling doaj-art-23e6145649344a58ba0904bf4c8c83852025-08-20T02:04:13ZengWileyCase Reports in Hematology2090-65602090-65792018-01-01201810.1155/2018/90794629079462A Rare Case of Triple-Negative Essential Thrombocythemia in a Young Postsplenectomy Patient: A Diagnostic ChallengeT. Akcan0P. Strati1M. Yan2M. Idowu3Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX, USADivision of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USADepartment of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX, USADivision of Hematology, University of Texas Health Science Center at Houston, Houston, TX, USAThe 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.http://dx.doi.org/10.1155/2018/9079462
spellingShingle T. Akcan
P. Strati
M. Yan
M. Idowu
A Rare Case of Triple-Negative Essential Thrombocythemia in a Young Postsplenectomy Patient: A Diagnostic Challenge
Case Reports in Hematology
title A Rare Case of Triple-Negative Essential Thrombocythemia in a Young Postsplenectomy Patient: A Diagnostic Challenge
title_full A Rare Case of Triple-Negative Essential Thrombocythemia in a Young Postsplenectomy Patient: A Diagnostic Challenge
title_fullStr A Rare Case of Triple-Negative Essential Thrombocythemia in a Young Postsplenectomy Patient: A Diagnostic Challenge
title_full_unstemmed A Rare Case of Triple-Negative Essential Thrombocythemia in a Young Postsplenectomy Patient: A Diagnostic Challenge
title_short A Rare Case of Triple-Negative Essential Thrombocythemia in a Young Postsplenectomy Patient: A Diagnostic Challenge
title_sort rare case of triple negative essential thrombocythemia in a young postsplenectomy patient a diagnostic challenge
url http://dx.doi.org/10.1155/2018/9079462
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