Thrombocytosis in rheumatoid arthritis: JAK2V617F-positive essential thrombocythemia.
Thrombocytosis is an important laboratory finding in rheumatoid arthritis (RA) and it has a correlation with disease activity. Janus kinase 2 valin 617 phenylalanine (JAK2V617F) mutation has gained importance in the diagnosis of myeloproliferative diseases recently. There is no published report in literature on the association between RA and JAK2V617F-positive essential thrombocythemia (ET). In this report, we present a JAK2V617F-positive ET case that had RA. A 57-year-old male patient was diagnosed with RA according to the criteria of American College of Rheumatology (ACR), whose complaint was of pain in the hands and morning stiffness lasting for about 2 h. The patient was evaluated for thrombocytosis because he was in remission and suffering persistent thrombocytosis under treatment. After excluding the causes of secondary thrombocytosis, bone marrow aspiration and biopsy was performed. On peripheral blood and bone marrow PCR examination, the patient was detected to be JAK2V617F positive heterozygously and diagnosed with ET. As a conclusion, mild-moderate thrombocytosis is frequent in RA; however, ET can be diagnosed by JAK2V617F evaluation in peripheral blood in thrombocytosis, especially when platelet count is more than 1 million/ml and when persisting thrombocytosis is detected in RA remission.
Divisions of Hematology, Adnan Menderes University Medical Faculty, 09100 Aydin, Turkey. drozlemayvaz@yahoo.com.tr
Ozlem Cırpan
OC
Ayvaz
Irfan
I
Yavasoglu
Gurhan
G
Kadikoylu
Gokay
G
Bozkurt
Zahit
Z
Bolaman
D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D001241:Aspirin / Q000627:therapeutic use; D015897:Comorbidity; D006801:Humans; D006918:Hydroxyurea / Q000627:therapeutic use; D053614:Janus Kinase 2 / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000235:genetics*; D010976:Platelet Count; D013920:Thrombocythemia, Essential / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D016896:Treatment Outcome
D018501:Antirheumatic Agents; C507924:JAK2 protein, human; D053614:Janus Kinase 2; D001241:Aspirin; D006918:Hydroxyurea
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