As several cases of clinically manifest HIT in ET patients have been reported (Table 1) and exclusively anti-PF4/heparin IgM were detectable in ET patients of our cohort, a potential implication of anti-PF4/heparin IgM for platelet activation in the setting of MPN with thrombocytosis may warrant further evaluation in functional studies. Here, CD40LG is linked to thrombocytosis disease.