Patients with essential thrombocytosis are usually asymptomatic. Symptoms of essential thrombocytosis include vision disturbances, transient loss of consciousness, chest pain, intense burning pain in hands or feet (erythromelalgia), numbness and tingling of hands and feet, and persistent and painful erection of the penis (priapism).^[1] Neurologic symptoms like headache may occur but the pathophysiology is not completely understood.^[1] A positive family history of the disease may be present in those with familial essential thrombocytosis.

• Patients may have symptoms of minimal bleeding that can go unnoticed until diagnosis. Most of the symptoms are vascular, either from thrombi occluding small and large blood vessels, though any blood vessel may be involved or from bleeding. Symptoms depend on the blood vessel that is involved.
• Symptoms of vascular occlusion may include:^[1][2]
  • Dizziness
  • Vision disturbances (transient monocular blindness, scintillating scotomas, blurred vision)
  • Chest pain
  • Transient ischemic attacks
  • Intense burning pain in hands or feet (erythromelalgia)
  • Numbness and tingling of hands and feet
  • Persistent and painful penile erections (Priapism)
• Symptoms from bleeding can occur despite the increased platelet count accounting to the dysfunctional platelets. Common sites of bleeding include eyes, nose (epistaxis), gums, gastrointestinal tract, and the skin (bruises). The bleeding itself is usually minimal.
• Neurologic symptoms like headache may occur but the pathophysiology is not completely understood.^[1]

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