Pampiniform venous plexus thrombosis in a 37 years-old male patient with severe thrombocytosis: a multifactorial aetiology.

Atypical thrombosis occurs in unconventional anatomical sites such as splanchnic, renal, gonadal, and cerebral venous vessels [1] . Genetic factors, as inherited thrombophilia could increase the risk of atypical thrombosis. Likewise, acquired disease, as cancer, autoimmune diseases (e.g. systemic lupus erythematosus and APS) or infections [e.g. Cytomegalovirus (CMV) and Epstein-Barr virus (EBV) infections], can trigger such an inflammatory response which lead to thrombocytosis and endothelial injury, thus promoting a hypercoagulability state [2,3] . Among cancers, myeloproliferative disorders are associated to an elevated risk of atypical thrombosis due to the increase in platelets or red blood cell count and the alteration of the balance between pro-coagulant e anticoagulant endothelial factors [4-6] . Other conditions that may predispose to atypical thrombotic events are platelet disfunction or structural abnormalities, chronic vascular diseases, pregnancy and medications. This case highlights the interplay of factors contributing to the development of thrombosis in an unconventional site and underscores the importance of a comprehensive diagnostic approach.