Essential Thrombocythaemia and Peripheral Gangrene

• Published in: British Medical Journal Vol. 3; no. 5930; pp. 548 - 552
• Main Authors: Preston, F. E., Emmanuel, I. G., Winfield, D. A., Malia, R. G.
• Format: Journal Article
• Language: English
• Published: England British Medical Journal Publishing Group 31.08.1974; British Medical Association; BMJ Publishing Group LTD
• Subjects: Adenosine Diphosphate - pharmacology; Adult; Aggregation; Amputation; Aspirin - therapeutic use; Blood Cell Count; Blood plasma; Collagen - pharmacology; Gangrene; Gangrene - complications; Gangrene - etiology; Humans; Male; Middle Aged; Pain; Papers and Originals; Peripheral vascular diseases; Phosphorus Radioisotopes - therapeutic use; Platelet aggregation; Platelet Aggregation - drug effects; Platelets; Thrombocythemia, Essential - complications; Thrombocythemia, Essential - drug therapy; Thrombocythemia, Essential - radiotherapy; Thrombocytosis; Toes
• ISSN: 0007-1447; 1468-5833
• DOI: 10.1136/bmj.3.5930.548

Six patients are described in whom gangrene of one or more toes occurred as the presenting feature of essential thrombocythaemia. Spontaneous platelet aggregation was observed in platelet-rich plasma from four patients and platelet aggregation after the addition of adenosine diphosphate and collagen was highly abnormal in samples from all six. All of the patients described dramatic relief of pain within six hours of ingestion of aspirin and this coincided with disappearance of the spontaneous platelet aggregation and collagen-induced platelet aggregation. Treatment with phosphorus-32 corrected the platelet count and there were no further recurrences of peripheral vascular disease. Platelet function tests performed at the time all gave normal results. It is concluded that essential thrombocythaemia is an important and treatable cause of peripheral vascular disease.