title: Myeloproliferative Disease: An Unusual Cause of Raynaud's Phenomenon and Digital Ischaemia.
abstract: We describe a 59-year-old female who presented with ischaemic digits, preceded by a 6-month history of Raynaud's phenomenon affecting her fingers and toes. There were no clinical or laboratory features of primary vasculitis or connective tissue disease, Doppler imaging was normal, and bloods were unremarkable aside from a platelet count of 786 × 109/L (150-400) and white cells of 16 × 109/L (4-11). In view of the thrombocytosis a JAK2 mutation assay was requested which confirmed a JAK2 V617F mutation, suggesting essential thrombocytosis (ET) as the cause. She received treatment with hydroxycarbamide which normalised her platelet count and led to a complete resolution of her Raynaud's symptoms. Raynaud's phenomenon is a rare manifestation of ET. Myeloproliferative disorders such as ET should be considered in the differential diagnosis of Raynaud's phenomenon and vasculitis.
authors.affiliation: Department of Rheumatology, Princess of Wales Hospital, Coity Road, Bridgend CF31 1RQ, UK.
authors.forename: Celia
authors.identifier: 0000-0001-9043-3210
authors.initials: C
authors.lastname: Beynon
authors.affiliation: Department of Rheumatology, Royal Gwent Hospital, Cardiff Road, Newport NP20 2UB, UK.
authors.forename: Gwenan
authors.initials: G
authors.lastname: Huws
authors.affiliation: Department of Rheumatology, Princess of Wales Hospital, Coity Road, Bridgend CF31 1RQ, UK.
authors.forename: Tom
authors.initials: T
authors.lastname: Lawson