Diagnostic Usefulness of the Janus Kinase 2 Mutation in non BCR/ABL Myeloproliferative Disorders
This 37 year-old male patient came to our emergency room with a severe back pain in February 2002. The chest X-ray and cardiologic evaluation revealed no abnormality. Gastrofibroscopy showed an active duodenal ulcer. His hemoglobin level was decreased to 10.0 g/dL. The peripheral blood smear showed microcytic and hypochromic RBCs with a serum ferritin level of 3.63µg/L. The WBC was 14,690/µL and PLT 885,000/µL. The BM examination showed a slightly increased cellularity (60%) with a normal M:E ratio. His initial diagnosis was duodenal ulcer and iron deficiency anemia with reactive thrombocytosis. At his last visit on June 2003, his CBC profile showed: 15.6 g/dL of hemoglobin, 12,600/µL of WBC, 563,000/µL of PLT. After that, no further information on his hematologic change and clinical course has been available. After the JAK2 testing, we re-diagnose this patient's disease as PV associated with duodenal ulcer bleeding that caused transient low hemoglobin levels.