BibTex RIS Kaynak Göster

Combination of Carotid Stenosis and Essential Thrombocythemia in a Male Patient with Homozygous JAK2 Mutation: Case Report

Yıl 2011, Cilt: 16 Sayı: 1, 38 - 40, 01.02.2011

Öz

A forty-six year-old male patient presented with complaints of syncopal attacks that last for 1-3 seconds, headache, and burning and redness on toes for the last two months. In his laboratory examination, platelet count was 1500x109/L, leukocyte count was 17x109/L, and hematocrit level was 55%. Janus Kinase 2 V617F (JAK2) homozygous mutation was detected with polymerase chain reaction (PCR). The patient was diagnosed with essential thrombocythemia (ET). In the evaluation of syncopal attacks, stenosis with a length of 2.5 cm, which constricted the right carotid artery lumen at a ratio of 65%, was detected. In this case report, the diagnosis and treatment modalities were discussed in a patient diagnosed with ET who has JAK2 mutation and carotis artery stenosis.

Kaynakça

  • 1. Tefferi A, Vardiman JW. Classification and diagnosis of myeloproliferative neoplasms: the 2008 World Health Organization criteria and point-of-care diagnostic algorithms. Leukemia 2008; 22: 14-22.
  • 2. Baxter EJ, Scott LM, Campbell PJ, et al. Acquired mutation of the tyrosine kinase JAK2 in human myeloproliferative disorders. Lancet 2005; 365: 1054-1061.
  • 3. Levine RL, Wadleigh M, Cools J, et al. Activating mutation in the tyrosine kinase JAK2 in polycythemia vera, essential thrombocythemia, and myeloid metaplasia with myelofibrosis. Cancer Cell 2005; 7: 387-397.
  • 4. James C, Ugo V, Le Couedic JP, et al. A unique clonal JAK2 mutation leading to constitutive signalling causes polycythaemia vera. Nature 2005; 434: 1144-1148.
  • 5. Kralovics R, Passamonti F, Buser AS, et all. A gain of function mutation of JAK2 in myeloproliferative disorders. N Engl J Med 2005; 350: 1779-1790.
  • 6. Tefferi A. Classification, diagnosis and management of myeloproliferative disorders in the JAK2V617F era. Hematology Am Soc Hematol Educ Program 2006; 240-245.
  • 7. Michiels JJ, Berneman Z, Van Bockstaele D. Clinical and laboratory features, pathobiology of platelet-mediated thrombosis and bleeding complications, and the molecular etiology of essential thrombocythemia and polycythemia vera: therapeutic implications. Semin Thromb Hemost 2006; 32: 174- 207.
  • 8. Mosso M, Georgiadis D, Baumgartner RW. Progressive occlusive disease of large cerebral arteries and ischemic events in a patient with essential thrombocythemia. Neurol Res 2004; 26: 702-703.
  • 9. Bellucci S, Michiels JJ. The role of JAK2 V617F mutation, spontaneous erythropoiesis and megakaryocytopoiesis, hypersensitive platelets, activated leukocytes, and endothelial cells in the etiology of thrombotic manifestations in polycythemia vera and essential thrombocythemia. Semin Thromb Hemost 2006; 32: 381-398.
  • 10. Bellanné-Chantelot C, Chaumarel I, Labopin M, France. Genetic and clinical implications of the Val617Phe JAK2 mutation in 72 families with myeloproliferative disorders. Blood 2006; 108: 346-352.
  • 11. Toyama K, Karasawa M, Yamane A et al. JAK2-V617F mutation analysis of granulocytes and platelets from patients with chronic myeloproliferative disorders: advantage of studying platelets. Br J Haematol 2007; 139: 64-69.
  • 12. Hirayama Y, Sakamaki S, Matsunaga T, et al. Concentrations of thrombopoietin in bone marrow in normal subjects and in patients with idiopathic thrombocytopenic purpura, aplastic anemia, and essential thrombocythemia correlate with its mRNA expression of bone marrow stromal cells. Blood 1998; 92: 46-52.
  • 13. Barth A. Carotid stenosis: diagnosis, patient selection, therapy. Ther Umsch 2003; 60: 563-568.
  • 14. van der Vaart MG, Meerwaldt R, Reijnen MM. Endarterectomy or carotid artery stenting: the quest continues. Am J Surg 2008; 195: 259-269.
  • 15. Kurabayashi H, Hishinuma A, Uchida R. Delayed manifestation and slow progression of cerebral infarction caused by polycythemia rubra vera. Am J Med Sci 2007; 333: 317-320.
  • 16. Pearson TC. The risk of thrombosis in essential thrombocythemia and polycythemia vera. Semin Oncol 2002; 9: 16-21.
  • 17. Cucuianu A, Stoia M, Farcaş A, Dima D, Zdrenghea M. Arterial stenosis and atherothrombotic events in polycythemia vera and essential thrombocythemia. Rom J Intern Med 2006; 44: 397-406.
  • 18. Friedman KD, Rodgers GM. Thrombosis and Antithrombotic Therapy. In: Greer JP, Foerster J, Lukens J, Rodgers G, Paraskevas F, Glader B (Editors). Wintrobe's Clinical Hematology. 11. Baskı, Philadelphia: Lippincott Williams& Wilkins, 2004: 1713-1728.

Homozigot JAK2 Mutasyonlu Erkek Hastada Karotis Stenozu ve Esansiyel Trombositemi Birlikteliği: Olgu Sunumu

Yıl 2011, Cilt: 16 Sayı: 1, 38 - 40, 01.02.2011

Öz

Kırk altı yaşında erkek hasta; son iki aydır, 1-3 saniye süren senkop atakları, baş ağrısı, ayak parmaklarında yanma ve kızarıklık şikayetleri ile başvurdu. Laboratuvar incelemesinde; trombosit sayısı 1500x109/L, lökosit sayısı 17x109/L, hematokrit düzeyi %55 idi. Polimeraz zincir reaksiyonu (PCR) ile Janus Kinaz 2 V617F (JAK2) homozigot mutasyonu tespit edildi. Hastaya esansiyel trombositemi (ET) tanısı kondu. Senkop ataklarına yönelik değerlendirmede sağ karotis arter lümenini %65 oranında daraltan, 2.5 cm uzunlukta stenoz saptandı. Bu olgu sunumunda; homozigot JAK2 mutasyonu taşıyan ve karotis arter stenozu saptanan ET tanılı olguda tanı ve tedavi yaklaşımları tartışılmıştır.

Kaynakça

  • 1. Tefferi A, Vardiman JW. Classification and diagnosis of myeloproliferative neoplasms: the 2008 World Health Organization criteria and point-of-care diagnostic algorithms. Leukemia 2008; 22: 14-22.
  • 2. Baxter EJ, Scott LM, Campbell PJ, et al. Acquired mutation of the tyrosine kinase JAK2 in human myeloproliferative disorders. Lancet 2005; 365: 1054-1061.
  • 3. Levine RL, Wadleigh M, Cools J, et al. Activating mutation in the tyrosine kinase JAK2 in polycythemia vera, essential thrombocythemia, and myeloid metaplasia with myelofibrosis. Cancer Cell 2005; 7: 387-397.
  • 4. James C, Ugo V, Le Couedic JP, et al. A unique clonal JAK2 mutation leading to constitutive signalling causes polycythaemia vera. Nature 2005; 434: 1144-1148.
  • 5. Kralovics R, Passamonti F, Buser AS, et all. A gain of function mutation of JAK2 in myeloproliferative disorders. N Engl J Med 2005; 350: 1779-1790.
  • 6. Tefferi A. Classification, diagnosis and management of myeloproliferative disorders in the JAK2V617F era. Hematology Am Soc Hematol Educ Program 2006; 240-245.
  • 7. Michiels JJ, Berneman Z, Van Bockstaele D. Clinical and laboratory features, pathobiology of platelet-mediated thrombosis and bleeding complications, and the molecular etiology of essential thrombocythemia and polycythemia vera: therapeutic implications. Semin Thromb Hemost 2006; 32: 174- 207.
  • 8. Mosso M, Georgiadis D, Baumgartner RW. Progressive occlusive disease of large cerebral arteries and ischemic events in a patient with essential thrombocythemia. Neurol Res 2004; 26: 702-703.
  • 9. Bellucci S, Michiels JJ. The role of JAK2 V617F mutation, spontaneous erythropoiesis and megakaryocytopoiesis, hypersensitive platelets, activated leukocytes, and endothelial cells in the etiology of thrombotic manifestations in polycythemia vera and essential thrombocythemia. Semin Thromb Hemost 2006; 32: 381-398.
  • 10. Bellanné-Chantelot C, Chaumarel I, Labopin M, France. Genetic and clinical implications of the Val617Phe JAK2 mutation in 72 families with myeloproliferative disorders. Blood 2006; 108: 346-352.
  • 11. Toyama K, Karasawa M, Yamane A et al. JAK2-V617F mutation analysis of granulocytes and platelets from patients with chronic myeloproliferative disorders: advantage of studying platelets. Br J Haematol 2007; 139: 64-69.
  • 12. Hirayama Y, Sakamaki S, Matsunaga T, et al. Concentrations of thrombopoietin in bone marrow in normal subjects and in patients with idiopathic thrombocytopenic purpura, aplastic anemia, and essential thrombocythemia correlate with its mRNA expression of bone marrow stromal cells. Blood 1998; 92: 46-52.
  • 13. Barth A. Carotid stenosis: diagnosis, patient selection, therapy. Ther Umsch 2003; 60: 563-568.
  • 14. van der Vaart MG, Meerwaldt R, Reijnen MM. Endarterectomy or carotid artery stenting: the quest continues. Am J Surg 2008; 195: 259-269.
  • 15. Kurabayashi H, Hishinuma A, Uchida R. Delayed manifestation and slow progression of cerebral infarction caused by polycythemia rubra vera. Am J Med Sci 2007; 333: 317-320.
  • 16. Pearson TC. The risk of thrombosis in essential thrombocythemia and polycythemia vera. Semin Oncol 2002; 9: 16-21.
  • 17. Cucuianu A, Stoia M, Farcaş A, Dima D, Zdrenghea M. Arterial stenosis and atherothrombotic events in polycythemia vera and essential thrombocythemia. Rom J Intern Med 2006; 44: 397-406.
  • 18. Friedman KD, Rodgers GM. Thrombosis and Antithrombotic Therapy. In: Greer JP, Foerster J, Lukens J, Rodgers G, Paraskevas F, Glader B (Editors). Wintrobe's Clinical Hematology. 11. Baskı, Philadelphia: Lippincott Williams& Wilkins, 2004: 1713-1728.
Toplam 18 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Makaleler
Yazarlar

Osman Yokuş Bu kişi benim

Süleyman Sırrı Gökalp Bu kişi benim

Özlem Şahin Balçık Bu kişi benim

Murat Albayrak Bu kişi benim

Mehmet Ersaydı Bu kişi benim

Yayımlanma Tarihi 1 Şubat 2011
Yayımlandığı Sayı Yıl 2011 Cilt: 16 Sayı: 1

Kaynak Göster

APA Yokuş, O., Gökalp, S. S., Balçık, Ö. Ş., Albayrak, M., vd. (2011). Homozigot JAK2 Mutasyonlu Erkek Hastada Karotis Stenozu ve Esansiyel Trombositemi Birlikteliği: Olgu Sunumu. Fırat Tıp Dergisi, 16(1), 38-40.
AMA Yokuş O, Gökalp SS, Balçık ÖŞ, Albayrak M, Ersaydı M. Homozigot JAK2 Mutasyonlu Erkek Hastada Karotis Stenozu ve Esansiyel Trombositemi Birlikteliği: Olgu Sunumu. Fırat Tıp Dergisi. Şubat 2011;16(1):38-40.
Chicago Yokuş, Osman, Süleyman Sırrı Gökalp, Özlem Şahin Balçık, Murat Albayrak, ve Mehmet Ersaydı. “Homozigot JAK2 Mutasyonlu Erkek Hastada Karotis Stenozu Ve Esansiyel Trombositemi Birlikteliği: Olgu Sunumu”. Fırat Tıp Dergisi 16, sy. 1 (Şubat 2011): 38-40.
EndNote Yokuş O, Gökalp SS, Balçık ÖŞ, Albayrak M, Ersaydı M (01 Şubat 2011) Homozigot JAK2 Mutasyonlu Erkek Hastada Karotis Stenozu ve Esansiyel Trombositemi Birlikteliği: Olgu Sunumu. Fırat Tıp Dergisi 16 1 38–40.
IEEE O. Yokuş, S. S. Gökalp, Ö. Ş. Balçık, M. Albayrak, ve M. Ersaydı, “Homozigot JAK2 Mutasyonlu Erkek Hastada Karotis Stenozu ve Esansiyel Trombositemi Birlikteliği: Olgu Sunumu”, Fırat Tıp Dergisi, c. 16, sy. 1, ss. 38–40, 2011.
ISNAD Yokuş, Osman vd. “Homozigot JAK2 Mutasyonlu Erkek Hastada Karotis Stenozu Ve Esansiyel Trombositemi Birlikteliği: Olgu Sunumu”. Fırat Tıp Dergisi 16/1 (Şubat 2011), 38-40.
JAMA Yokuş O, Gökalp SS, Balçık ÖŞ, Albayrak M, Ersaydı M. Homozigot JAK2 Mutasyonlu Erkek Hastada Karotis Stenozu ve Esansiyel Trombositemi Birlikteliği: Olgu Sunumu. Fırat Tıp Dergisi. 2011;16:38–40.
MLA Yokuş, Osman vd. “Homozigot JAK2 Mutasyonlu Erkek Hastada Karotis Stenozu Ve Esansiyel Trombositemi Birlikteliği: Olgu Sunumu”. Fırat Tıp Dergisi, c. 16, sy. 1, 2011, ss. 38-40.
Vancouver Yokuş O, Gökalp SS, Balçık ÖŞ, Albayrak M, Ersaydı M. Homozigot JAK2 Mutasyonlu Erkek Hastada Karotis Stenozu ve Esansiyel Trombositemi Birlikteliği: Olgu Sunumu. Fırat Tıp Dergisi. 2011;16(1):38-40.