title: Medical Management of Extensive Arterial Thromboembolism in a Patient with Essential Thrombocythemia and Warfarin Failure.
abstract: Chronic myeloproliferative disorders share a stem cell-derived clonal myeloproliferation. This group of disorders include essential thrombocythemia (ET), polycythemia vera (PV), chronic myeloid leukemia, and primary myelofibrosis (PMF), with the respective features of thrombocytosis, erythrocytosis, and bone marrow fibrosis. These disorders can be associated with genetic mutations affecting protein tyrosine kinases, resulting in different configurations of abnormal signal transduction. The Janus tyrosine kinase 2 mutation can be used as a key diagnostic tool for diagnosing MPDs, specifically, ET, PV, and PMF. Patients with ET and PV are at an increased risk for thromboembolic and hemorrhagic events. We present a unique case of ET causing extensive arterial thromboembolism, despite being on adequate antithrombotic agents including warfarin and aspirin.
authors.affiliation: Minneapolis Heart Institute Research Foundation, Abbott Northwestern Hospital, Minneapolis, MN.
authors.forename: Aisha K
authors.initials: AK
authors.lastname: Ahmed
authors.affiliation: Minneapolis Heart Institute Research Foundation, Abbott Northwestern Hospital, Minneapolis, MN.
authors.forename: Alicia
authors.initials: A
authors.lastname: Youssef
authors.affiliation: Minneapolis Heart Institute Research Foundation, Abbott Northwestern Hospital, Minneapolis, MN. Electronic address: nedaa.skeik@allina.com.
authors.forename: Nedaa
authors.initials: N
authors.lastname: Skeik
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D001777:Blood Coagulation / Q000187:drug effects*; D001780:Blood Coagulation Tests; D000072226:Computed Tomography Angiography; D057915:Drug Substitution; D017984:Enoxaparin / Q000627:therapeutic use*; D006801:Humans; D006918:Hydroxyurea / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D013920:Thrombocythemia, Essential / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D013923:Thromboembolism / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D017211:Treatment Failure; D016896:Treatment Outcome; D014859:Warfarin / Q000627:therapeutic use*
chemical_list: D000925:Anticoagulants; D017984:Enoxaparin; D014859:Warfarin; D006918:Hydroxyurea