TY - JOUR
T1 - A unique case of bleeding from esophageal varices as the first sign of essential thrombocythemia
AU - Brito, Mariana
AU - Nunes, Gonçalo
AU - Laranjo, Ana
AU - Sabino, Júlia
AU - Oliveira, Carla
AU - Valle, Sara
AU - Gonçalves, Diogo
AU - Fonseca, Jorge
N1 - Publisher Copyright:
© 2021, Japanese Society of Gastroenterology.
PY - 2021/12
Y1 - 2021/12
N2 - Upper gastrointestinal bleeding (UGIB) is a common cause of hospital admission and variceal hemorrhage is responsible for many UGIB cases. Esophageal and gastric varices are caused by portal hypertension (PHT), mostly due to liver cirrhosis. Portal vein thrombosis (PVT) is an important cause of non-cirrhotic PHT and can be associated with several diseases, including myeloproliferative disorders such as essential thrombocythemia (ET). PVT may become apparent due to complications of PHT, including variceal bleeding (VB). We report the case of a 43-year-old male admitted with esophageal VB. Etiologic work-up for chronic liver disease was negative and abdominal magnetic resonance imaging revealed chronic PVT with cavernous transformation and a non-cirrhotic liver. JAK2 mutation was found, and the bone-marrow biopsy was consistent with ET, without peripheral blood alterations. This is a unique case of ET diagnosed in a variceal bleeding setting, remembering the necessity for high clinical suspicion.
AB - Upper gastrointestinal bleeding (UGIB) is a common cause of hospital admission and variceal hemorrhage is responsible for many UGIB cases. Esophageal and gastric varices are caused by portal hypertension (PHT), mostly due to liver cirrhosis. Portal vein thrombosis (PVT) is an important cause of non-cirrhotic PHT and can be associated with several diseases, including myeloproliferative disorders such as essential thrombocythemia (ET). PVT may become apparent due to complications of PHT, including variceal bleeding (VB). We report the case of a 43-year-old male admitted with esophageal VB. Etiologic work-up for chronic liver disease was negative and abdominal magnetic resonance imaging revealed chronic PVT with cavernous transformation and a non-cirrhotic liver. JAK2 mutation was found, and the bone-marrow biopsy was consistent with ET, without peripheral blood alterations. This is a unique case of ET diagnosed in a variceal bleeding setting, remembering the necessity for high clinical suspicion.
KW - Esophageal varices
KW - Essential thrombocythemia
KW - JAK-2 mutation
KW - Non-cirrhotic portal hypertension
KW - Upper gastrointestinal bleeding
UR - http://www.scopus.com/inward/record.url?scp=85111827098&partnerID=8YFLogxK
U2 - 10.1007/s12328-021-01495-3
DO - 10.1007/s12328-021-01495-3
M3 - Article
C2 - 34342841
AN - SCOPUS:85111827098
SN - 1865-7257
VL - 14
SP - 1612
EP - 1616
JO - Clinical Journal of Gastroenterology
JF - Clinical Journal of Gastroenterology
IS - 6
ER -