Acute Management of Essential Thrombocythemia

Patients presenting with ET-related hemorrhage may paradoxically need platelet transfusion to increase the number of normally functioning platelets. Platelet apheresis to reduce the platelet count rapidly while the response to hydroxyurea is awaited has sometimes been used for both persisting hemorrhage and evolving thrombosis. Early use of aspirin (300 mg) in ischemic or thrombotic situations is recommended, and anticoagulation with heparin or warfarin can be considered. Some bleeding patients with ET have an acquired von Willebrand's disease. The use of desmopressin and von Willebrand's factor concentrate is an option in this situation.

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