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J Thromb Thrombolysis ; 50(4): 995-1003, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32266587

RESUMO

To determine the prevalence of the V617F Janus Kinase 2 (JAK2) mutation in patients with thrombosis without other biological signs of underlying myeloproliferative neoplasm (MPN) and identify associated risk factors for thrombosis. Over a 10-year period, data were collected from patients with thrombotic events and who had also been screened for the V617F JAK2 mutation. Patients with signs of underlying MPN, such as haematocrit levels ≥ 50% and/or platelet counts ≥ 450 × 109/L and/or splanchnic thrombosis were excluded from the study. Of 340 patients fulfilling inclusion criteria, JAK2 mutation was found in 9 (2.65%), the allele burden being at least 2% in 4 (1.1%). Upon follow-up, MPN was diagnosed in the latter 4. Univariate analysis of the whole cohort showed that age (54 ± 15 vs. 64 ± 13, p = 0.027), platelet count (317 ± 111 vs. 255 ± 75, p = 0.017), C-reactive protein level > 5 mg/L (OR 7.29, p = 0.014), and splenomegaly (OR 54.5, p = 0.0002) were significantly associated with JAK2 mutation. There was also a trend for an increased risk of cerebral venous thrombosis (OR 6.54, p = 0.064). Logistic regression confirmed a significant association between splenomegaly and JAK2 mutation (OR 43.15 [95%CI, 3.05-610.95], p = 0.0054). The V617F JAK2 mutation is rarely found in patients with thrombotic events without overt MPN. Splenomegaly, however, is a statistically and clinically relevant indicator of a potential JAK2 mutation in patients with non-splanchnic thrombotic events. Such patients should require further assessment and a close follow-up.


Assuntos
Trombose Intracraniana , Janus Quinase 2/genética , Transtornos Mieloproliferativos , Esplenomegalia/diagnóstico por imagem , Trombose , Proteína C-Reativa/análise , Estudos de Coortes , Feminino , França/epidemiologia , Predisposição Genética para Doença , Humanos , Trombose Intracraniana/etiologia , Trombose Intracraniana/prevenção & controle , Masculino , Pessoa de Meia-Idade , Mutação , Transtornos Mieloproliferativos/classificação , Transtornos Mieloproliferativos/epidemiologia , Transtornos Mieloproliferativos/genética , Contagem de Plaquetas/métodos , Prevalência , Medição de Risco , Fatores de Risco , Trombose/sangue , Trombose/epidemiologia , Trombose/genética , Trombose/fisiopatologia , Trombose Venosa
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