Τίτλος:
JAK2V617F positive polycythemia vera with paroxysmal nocturnal hemoglobinuria and visceral thromboses: a case report and review of the literature
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background: Polycythemia vera (PV) is characterized by red cell mass expansion in the peripheral blood and can be complicated with thrombosis, bleeding, evolution to acute myeloid leukemia (AML) or a fibrotic phase. Paroxysmal nocturnal hemoglobinuria (PNH) in an acquired clonal haematopoietic stem cell disorder associated with chronic intravascular hemolysis, venous thrombosis, defective hematopoiesis, frequent episodes of infection and, rarely, leukemic transformation. Herein, we report an interesting case of a patient with coexistence of PNH clones and a JAK2V617F positive PV, with unusual thromboses without hemolysis. Case presentation: A 51-year-old woman presented with increased levels of hematocrit, multiple liver, spleen, and left kidney infarctions and ascites; further investigation revealed a JAK2V617F-positive polycythemia vera and the presence of a significant PNH population (more than 90% CD55– CD59– cells among both granulocytes and red blood cells). Interestingly, the patient has experienced severe thrombotic events without any signs or symptoms of hemolysis. Conclusions: This case raises questions over uncharted aspects of the PNH etiopathogenesis and its potential association with myeloproliferative neoplasms (MPN) and highlights the difficulty of diagnosing and managing patients with more than one potentially thrombophilic conditions, especially with established and severe thromboses. © 2021, The Author(s).
Συγγραφείς:
Chatzidavid, S.
Giannakopoulou, N.
Diamantopoulos, P.T.
Gavriilaki, E.
Katsiampoura, P.
Lakiotaki, E.
Sakellariou, S.
Viniou, N.-A.
Dryllis, G.
Περιοδικό:
Thrombosis Journal
Εκδότης:
BioMed Central Ltd.
Λέξεις-κλειδιά:
acenocoumarol; eculizumab; enoxaparin; hydroxyurea; Meningococcus vaccine, abdominal distension; abdominal pain; abdominal radiography; adult; Article; ascites; beta thalassemia; blood analysis; bone marrow biopsy; Budd Chiari syndrome; case report; cholecystectomy; clinical article; computed tomographic angiography; computer assisted tomography; disease severity; drug substitution; dyserythropoiesis; emergency ward; endoscopy; epigastric pain; female; flow cytometry; hepatomegaly; human; human tissue; hypertransaminasemia; JAK2V617F gene; kidney infarction; liver biopsy; liver infarction; medical history; middle aged; paroxysmal nocturnal hemoglobinuria; polycythemia vera; polymerase chain reaction; portal hypertension; pruritus; spleen infarction; splenomegaly; stomach disease; thrombophilia; thrombosis; thyroid hyperplasia; visceral thrombosis
DOI:
10.1186/s12959-021-00269-8
