Essential Thrombocythemia Possible Cause of Ischemic Cerebrovascular Disease: A Case Report

Essential thrombocythemia (ET) is a rare, chronic myeloproliferative neoplasm characterized by the overproduction of platelets. ET is of significant clinical importance due to thrombotic and hemorrhagic cerebrovascular disease. The JAK2 V617F mutation has been identified in approximately 50-60% of ET cases. Our case report: a 41-year-old male presented to the hospital with a one-day history of vertigo, ataxic gait, and vomiting. The patient was diagnosed with ET at an external center two years ago. The JAK2 V617F mutation was detected. He regularly uses acetylsalicylic acid 100 mg per day. Magnetic resonance imaging (MRI) showed an acute infarction involving the bilateral cerebellar hemisphere, thalamic area, and right occipital area. Computed Tomography Angiography showed that no significant stenosis was detected in major branches. The patient was diagnosed with ischemic cerebrovascular disease for ET. Antiplatelet therapy was started with acetylsalicylic acid 100 mg and clopidogrel 75 mg once a day. With the recommendation of hematology, cytoreductive treatment, hydroxyurea 1000 mg twice a day, was started. The patient's complaints were resolved at the end of the second day, and the patient with minimal ataxia was discharged with recommendations. Patients with ET should be aware of ischemic cerebrovascular disease and consider antiplatelet and cytoreductive treatment options.