Essential Thrombocythemia and Ischemic Stroke: A Case Series of Five JAK2-Positive Patients

Medicina (Kaunas). 2023 Jul 14;59(7):1300. doi: 10.3390/medicina59071300.

Abstract

Background and Objectives: Essential thrombocythemia (ET) is a chronic myeloproliferative neoplasm characterized by elevated platelet counts and an increased risk of thrombotic events, including ischemic strokes. Materials and Methods: We conducted a retrospective analysis of data from consecutive ischemic stroke patients with ET between March 2014 and February 2023. Results: This case series describes the clinical presentation, radiological features, and management of five patients with ET-associated ischemic strokes, all harboring the JAK2 mutation. The diverse radiological findings suggest that both large and small vessel diseases may be influenced by the prothrombotic state induced by ET. A significant elevation in platelet count was observed to correlate with the emergence of new acute infarctions in some cases. Conclusions: The study highlights combined use of antiplatelet and cytoreductive therapy in preventing secondary stroke events in patients with ET and JAK2 mutations. The heterogeneity of stroke patterns in this population necessitates a comprehensive understanding of the underlying pathophysiological mechanisms and tailored therapeutic approaches.

Keywords: JAK2; cytoreductive therapy; essential thrombosis; ischemic stroke; recurrent stroke.

MeSH terms

  • Humans
  • Ischemic Stroke* / complications
  • Janus Kinase 2 / genetics
  • Mutation
  • Retrospective Studies
  • Stroke* / complications
  • Thrombocythemia, Essential* / complications
  • Thrombocythemia, Essential* / genetics
  • Thrombosis* / etiology

Substances

  • JAK2 protein, human
  • Janus Kinase 2