Gangrene and osteomyelitis of the toe in a previously healthy patient due to undiagnosed essential thrombocythemia.

Autor:	Schick A; Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA alex_schick@urmc.rochester.edu., Dhamoon AS; Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.
Jazyk:	angličtina
Zdroj:	BMJ case reports [BMJ Case Rep] 2024 Oct 07; Vol. 17 (10). Date of Electronic Publication: 2024 Oct 07.
DOI:	10.1136/bcr-2024-261063
Abstrakt:	We report a case of gangrene and osteomyelitis of the toe in a young, previously healthy male with undiagnosed essential thrombocythemia (ET). The patient experienced persistent right fifth toe pain, discolouration and ulceration for 3-4 months, unresponsive to antibiotics. Despite multiple normal X-rays, 2 months later, MRI revealed osteomyelitis. On inpatient admission, testing revealed thrombocytosis and abnormal blood flow to right fourth and fifth toes without thrombus, consistent with vasospasm. This ultimately resulted in ischemia, gangrene and osteomyelitis of the toe, necessitating amputation. The patient was subsequently treated with hydroxyurea for ET. This unusual presentation underscores the importance of a broad differential in cases when conventional treatments fail to yield improvement. Competing Interests: Competing interests: None declared. (© BMJ Publishing Group Limited 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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