Ischemia of Toes as a Presenting Symptom in Primary Thrombosis: A Case Report

Although thrombotic occlusion of small vessels in thrombocytosis is alleg edly well recognized, it has been reported only rarely. We treated 4 patients with primary thrombocytosis in whom ischemic toe lesions with normal peripheral pulses were the presenting and only symptoms. The symptoms preceded diagno sis by 5 years, 3 years, 1 year, and 1 month respectively. Treatment of the hematologic disorder resulted in disappearance of the toe lesions. Thrombocy tosis should be routinely searched for in patients with ischemic toes and normal peripheral pulses.