The JAK2 V617F mutation frequently occurs in patients with portal and mesenteric venous thrombosis.
BACKGROUND
Myeloproliferative disorders (MPDs) represent a risk factor for thrombosis in the portal, mesenteric, and hepatic districts.


OBJECTIVE
We aimed to assess whether the Janus kinase 2 (JAK2) V617F mutation, an acquired mutation that occurs in MPD patients, is a risk factor for portal and mesenteric venous thrombosis (PMVT) independently of the presence of overt MPDs.


METHODS
The medical histories of 99 patients presenting with PMVT were obtained. The presence of the JAK2 V617F and VHL 598C > T mutations was determined by polymerase chain reaction followed by restriction enzyme analysis and direct cycle sequence analysis.


RESULTS
Over a 10-year period of observation, of the 99 patients presenting with PMVT, the JAK2 V617F mutation was detected in heterozygous state in 17 individuals [17.2%; 95% confidence interval (95% CI) 10.9-25.9]. None of the patients presenting with the JAK2 V617F mutation carried an inherited thrombophilic risk factor. Seven patients with (43.8%; 95% CI 19.8-70.1) and two without (2.4%; 95% CI 0.3-8.4) the JAK2 V617F mutation had a diagnosis of MPD at the occurrence of the venous thrombotic event. After a median follow-up of 41 months (range 3-114 months), three out of the 10 patients carrying the JAK2 V617F mutation were then diagnosed as having idiopathic myelofibrosis (n = 2) or polycythemia vera (n = 1), whereas in seven patients a MPD was not detected. Two of the 83 patients without the JAK2 V617F mutation went on to develop MPDs.


CONCLUSIONS
Determination of the JAK2 V617F mutation may contribute to the search for genetic determinants of PMVT and may be useful to recognize patients who should be carefully observed for the subsequent development of overt MPDs.
Colaizzo
D
D
Unita' di Aterosclerosi e Trombosi, IRCCS Casa Sollievo della Sofferenza, S. Giovanni Rotondo, Foggia, Italy.
Amitrano
L
L
Tiscia
G L
GL
Scenna
G
G
Grandone
E
E
Guardascione
M A
MA
Brancaccio
V
V
Margaglione
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005787:Gene Frequency; D020022:Genetic Predisposition to Disease; D006801:Humans; D007558:Italy; D053614:Janus Kinase 2 / Q000235:genetics*; D008297:Male; D008641:Mesenteric Vascular Occlusion / Q000209:etiology / Q000235:genetics* / Q000473:pathology; D008642:Mesenteric Veins; D008875:Middle Aged; D009154:Mutation; D009196:Myeloproliferative Disorders / Q000235:genetics; D016017:Odds Ratio; D010649:Phenylalanine; D011169:Portal Vein / Q000473:pathology; D012307:Risk Factors; D013997:Time Factors; D014633:Valine; D020246:Venous Thrombosis / Q000209:etiology / Q000235:genetics* / Q000473:pathology; D051794:Von Hippel-Lindau Tumor Suppressor Protein / Q000235:genetics
D010649:Phenylalanine; D051794:Von Hippel-Lindau Tumor Suppressor Protein; C507924:JAK2 protein, human; D053614:Janus Kinase 2; C497446:VHL protein, human; D014633:Valine