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Erythromelalgia in ET — RACP Adult Medicine MCQ

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EasyHaematologyErythromelalgia in ETRACP Adult Medicine

A 55-year-old man with essential thrombocythaemia (JAK2 V617F positive) develops erythromelalgia (burning pain and redness of the fingers). His platelet count is 850 × 10⁹/L. What is the first-line treatment for erythromelalgia?

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Correct answer: E — Low-dose aspirin

Erythromelalgia is a microvascular thrombotic complication of myeloproliferative neoplasms characterised by burning pain, warmth, and erythema of the extremities (typically hands and feet). It responds dramatically to low-dose aspirin (100 mg daily), which inhibits platelet-mediated thromboxane A₂ production causing the microvascular occlusion. Cytoreductive therapy (hydroxyurea) is added for high-risk patients to reduce the platelet count and prevent major thrombotic events.

Reference: eTG – 2025 – Haematology; EHA – 2022 – MPN Guidelines