Hemorrhagic Transformation After Ischemic Stroke in a Case of Essential Thrombocythemia with Hyperfibrinolysis on Thromboelastography

Essential thrombocythemia (ET) is a myeloproliferative neoplasm that is characterized by thrombocytosis. Because it is characterized by thromboembolic and hemorrhagic events, balancing the coagulation status is essential. Thromboelastography (TEG) is a point-of-care viscoelastic test that evaluates whole-blood coagulation dynamics. We herein describe the case of a patient with ischemic stroke accompanied by ET who underwent TEG. The lysis index after 30 min (LY30) was elevated when hemorrhagic transformation occurred. After augmentation with cytoreductive therapy, the platelet count and LY30 levels rapidly normalized. Our findings indicate that TEG may be therefore useful for monitoring the complicated coagulation status of ET patients.