Splanchnic venous thrombosis and recurrent spontaneous abortion due to latent essential thrombocytosis revealed after 20 years: Case report.

A 50-year old housewife presented to our department with recurrent pain and bluish discoloration of bilateral lateral two toes for 1 year. She had multiple thrombotic complications (portal vein thrombosis, small bowel ischemia, and recurrent abortions) at the age of 30 years for which a cause was not identified. She had a long asymptomatic period of 20 years following that and was diagnosed to have essential thrombocytosis (ET) when she was admitted with digital ischemia. She was started on hydroxyurea and aspirin. She had significant improvement in her ischemic symptoms and the platelet counts and white blood counts came down on follow-up. We present a patient with multiple thrombotic complications during the masked phase of ET (with normal platelet counts) which was not reported previously to the best of our knowledge. A very long asymptomatic period of 20 years between the first thrombotic event and the later events revealing the diagnosis of ET is unusual.