A case of simultaneous acute cardio-cerebral infarction in a woman with essential thrombocythemia

Essential thrombocythemia (ET) can cause arterial embolism. Patients with arterial thrombosis usually have additional risk factors, such as smoking and hypertension. We report a 70-year-old woman with ET who had no risk factors, except for age. Cranial magnetic resonance imaging showed fresh lacunar infarction in several lobes. Electrocardiography showed ST-segment elevation in leads II, III, and aVF. Coronary angioplasty and stenting were successfully performed. We checked the bone marrow and performed genetic testing. The Janus kinase 2 (JAK2) V617F gene mutation was found. This case was a rare initial presentation of previously undiagnosed ET with embolism of cardiovascular and cerebral vessels. Anti-platelet drugs and hydroxyurea were used to prevent further thrombosis in the coronary and cerebral arteries.