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Published in: BMC Nephrology 1/2013

Open Access 01-12-2013 | Case report

Splanchnic vein thrombosis following renal transplantation: a case report

Authors: Erhan Tatar, Adam Uslu, Ahmet Aykas, Funda Tasli, Ozgur Oztekin, Gulsum Akgun Cagliyan

Published in: BMC Nephrology | Issue 1/2013

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Abstract

Background

Recurrent episodes of venous thrombosis have been closely correlated with JAK2 V617F mutation. Upto date, JAK2 gene mutation has not been defined as a prothrombic risk factor in renal transplant recipients. Herein; we present a case of portosplenic vein thrombosis in a primary renal transplant recipient with JAK2 V617F mutation who had no history of prior venous thromboembolism or thrombophilia.

Case presentation

A 59 year old female caucasian patient with primary kidney transplant admitted with vague abdominal pain at left upper quadrant. Abdominal doppler ultrasound and magnetic resonance imaging angiography demonstrated splanchnic vein thrombosis (SVT). The final diagnosis was SVT due to MPD (essential thrombocytosis, ET) with JAK2 V617F mutation. After 3 months of treatment with warfarin (≥5 mg/day, to keep target INR values of 1.9-2.5), control MRI angiography and doppler USG demonstrated partial (>%50) resolution of thrombosis with recanalization of hepatopedal venous flow. The patient is still on the same treatment protocol without any complication.

Conclusion

JAK2 V617F mutation analysis should be a routine procedure in the diagnosis and treatment of kidney transplant patients with thrombosis in uncommon sites.
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Literature
1.
go back to reference Jofre R, Lopez-Gomez JM, Moreno F, et al: Changes in quality of life after renal transplantation. Am J Kidney Dis. 1998, 32: 93-100. 10.1053/ajkd.1998.v32.pm9669429.CrossRefPubMed Jofre R, Lopez-Gomez JM, Moreno F, et al: Changes in quality of life after renal transplantation. Am J Kidney Dis. 1998, 32: 93-100. 10.1053/ajkd.1998.v32.pm9669429.CrossRefPubMed
2.
go back to reference Poli D, Zanazzi M, Antonucci E, et al: Renal transplant recipients are at high risk for both symptomatic and asymptomatic deep vein thrombosis. J Thromb Haemost. 2006, 4: 988-992. 10.1111/j.1538-7836.2006.01917.x.CrossRefPubMed Poli D, Zanazzi M, Antonucci E, et al: Renal transplant recipients are at high risk for both symptomatic and asymptomatic deep vein thrombosis. J Thromb Haemost. 2006, 4: 988-992. 10.1111/j.1538-7836.2006.01917.x.CrossRefPubMed
3.
go back to reference Kazory A, Ducloux D: Acquired hypercoagulable state in renal transplant recipients. J Thromb Haemost. 2004, 91: 646- Kazory A, Ducloux D: Acquired hypercoagulable state in renal transplant recipients. J Thromb Haemost. 2004, 91: 646-
4.
go back to reference Heidenreich S, Junker R, Wolters H, et al: Outcome of kidney transplantation in patients with inherited thrombophilia: data of a prospective study. J Am Soc Nephrol. 2003, 14: 234-239. 10.1097/01.ASN.0000039567.22063.9D.CrossRefPubMed Heidenreich S, Junker R, Wolters H, et al: Outcome of kidney transplantation in patients with inherited thrombophilia: data of a prospective study. J Am Soc Nephrol. 2003, 14: 234-239. 10.1097/01.ASN.0000039567.22063.9D.CrossRefPubMed
5.
go back to reference Levine RL, Pardanani A, Tefferi A, Gilliland DG: Role of JAK2 in the pathogenesis and therapy of myeloproliferative disorders. Nat Rev Cancer. 2007, 7: 673-683. 10.1038/nrc2210.CrossRefPubMed Levine RL, Pardanani A, Tefferi A, Gilliland DG: Role of JAK2 in the pathogenesis and therapy of myeloproliferative disorders. Nat Rev Cancer. 2007, 7: 673-683. 10.1038/nrc2210.CrossRefPubMed
6.
go back to reference James C, Ugo V, Le Couedic JP, et al: A unique clonal JAK2 mutation leading to constitutive signaling causes polycythemia vera. Nature. 2005, 434: 1144-1148. 10.1038/nature03546.CrossRefPubMed James C, Ugo V, Le Couedic JP, et al: A unique clonal JAK2 mutation leading to constitutive signaling causes polycythemia vera. Nature. 2005, 434: 1144-1148. 10.1038/nature03546.CrossRefPubMed
7.
go back to reference Baxter EJ, Scott LM, Campbell PJ, et al: Cancer Genome Project. Acquired mutation of the tyrosine kinase JAK2 in human myeloproliferative disorders. Lancet. 2005, 365: 1054-1061.CrossRefPubMed Baxter EJ, Scott LM, Campbell PJ, et al: Cancer Genome Project. Acquired mutation of the tyrosine kinase JAK2 in human myeloproliferative disorders. Lancet. 2005, 365: 1054-1061.CrossRefPubMed
8.
go back to reference De Stefano V, Fiorini A, Rossi E, et al: Incidence of the JAK2 V617F mutation among patients with splanchnic or cerebral venous thrombosis and without overt chronic myeloproliferative disorders. J Thromb Haemost. 2007, 5: 708-714. 10.1111/j.1538-7836.2007.02424.x.CrossRefPubMed De Stefano V, Fiorini A, Rossi E, et al: Incidence of the JAK2 V617F mutation among patients with splanchnic or cerebral venous thrombosis and without overt chronic myeloproliferative disorders. J Thromb Haemost. 2007, 5: 708-714. 10.1111/j.1538-7836.2007.02424.x.CrossRefPubMed
9.
go back to reference De Stefano V, Martinelli I: Splanchnic vein thrombosis: clinical presentation, risk factors and treatment. Intern Emerg Med. 2010, 5: 487-494. 10.1007/s11739-010-0413-6.CrossRefPubMed De Stefano V, Martinelli I: Splanchnic vein thrombosis: clinical presentation, risk factors and treatment. Intern Emerg Med. 2010, 5: 487-494. 10.1007/s11739-010-0413-6.CrossRefPubMed
10.
go back to reference Riva N, Donadini MP, Dentali F, et al: Clinical approach to splanchnic vein thrombosis: risk factors and treatment. Thromb Res. 2012, 130 (Suppl 1): S1-S3.CrossRefPubMed Riva N, Donadini MP, Dentali F, et al: Clinical approach to splanchnic vein thrombosis: risk factors and treatment. Thromb Res. 2012, 130 (Suppl 1): S1-S3.CrossRefPubMed
11.
go back to reference Donadini MP, Dentali F, Ageno W: Splanchnic vein thrombosis: new risk factors and management. Thromb Res. 2012, 129 (Suppl 1): S93-S96.CrossRefPubMed Donadini MP, Dentali F, Ageno W: Splanchnic vein thrombosis: new risk factors and management. Thromb Res. 2012, 129 (Suppl 1): S93-S96.CrossRefPubMed
12.
go back to reference Irish AB, Green FR: Environmental and genetic determinants of the hypercoagulable state and cardiovascular disease in renal transplant recipients. Nephrol Dial Transplant. 1997, 12: 167-173. 10.1093/ndt/12.1.167.CrossRefPubMed Irish AB, Green FR: Environmental and genetic determinants of the hypercoagulable state and cardiovascular disease in renal transplant recipients. Nephrol Dial Transplant. 1997, 12: 167-173. 10.1093/ndt/12.1.167.CrossRefPubMed
13.
go back to reference Irish A: Hypercoagulability in renal transplant recipients. Identifying patients at risk of renal allograft thrombosis and evaluating strategies for prevention. Am J Cardiovasc Drugs. 2004, 4: 139-149. 10.2165/00129784-200404030-00001.CrossRefPubMed Irish A: Hypercoagulability in renal transplant recipients. Identifying patients at risk of renal allograft thrombosis and evaluating strategies for prevention. Am J Cardiovasc Drugs. 2004, 4: 139-149. 10.2165/00129784-200404030-00001.CrossRefPubMed
14.
go back to reference Lijfering WM, de Vries AP, Veeger NJ, et al: Possible contribution of cytomegalovirus infection to the high risk of (recurrent) venous thrombosis after renal transplantation. Thromb Haemost. 2008, 99: 127-132.PubMed Lijfering WM, de Vries AP, Veeger NJ, et al: Possible contribution of cytomegalovirus infection to the high risk of (recurrent) venous thrombosis after renal transplantation. Thromb Haemost. 2008, 99: 127-132.PubMed
15.
go back to reference Trotter JF: Sirolimus in liver transplantation. Transplant Proc. 2003, 35: 193-200. 10.1016/S0041-1345(03)00234-3.CrossRef Trotter JF: Sirolimus in liver transplantation. Transplant Proc. 2003, 35: 193-200. 10.1016/S0041-1345(03)00234-3.CrossRef
16.
go back to reference Ripert T, Menard J, Schoepen Y, et al: Preventing graft thrombosis after renal transplantation: a multicenter survey of clinical practice. Transplant Proc. 2009, 41: 4193-4196. 10.1016/j.transproceed.2009.07.106.CrossRefPubMed Ripert T, Menard J, Schoepen Y, et al: Preventing graft thrombosis after renal transplantation: a multicenter survey of clinical practice. Transplant Proc. 2009, 41: 4193-4196. 10.1016/j.transproceed.2009.07.106.CrossRefPubMed
17.
go back to reference Murashima M, Konkle BA, Bloom RD, et al: A single-center experience of preemptive anticoagulation for patients with risk factors for allograft thrombosis in renal transplantation. Clin Nephrol. 2010, 74: 351-357.CrossRefPubMed Murashima M, Konkle BA, Bloom RD, et al: A single-center experience of preemptive anticoagulation for patients with risk factors for allograft thrombosis in renal transplantation. Clin Nephrol. 2010, 74: 351-357.CrossRefPubMed
18.
go back to reference Xavier SG, Gadelha T, Rezende SM, et al: JAK2V617F mutation in patients with thrombosis: to screen or not to screen?. Int J Lab Hematol. 2011, 33: 117-124. 10.1111/j.1751-553X.2010.01275.x.CrossRefPubMed Xavier SG, Gadelha T, Rezende SM, et al: JAK2V617F mutation in patients with thrombosis: to screen or not to screen?. Int J Lab Hematol. 2011, 33: 117-124. 10.1111/j.1751-553X.2010.01275.x.CrossRefPubMed
19.
go back to reference Colaizzo D, Tiscia GL, Bafunno V, et al: Sex modulation of the occurrence of jak2 v617f mutation in patients with splanchnic venous thrombosis. Thromb Res. 2011, 128: 233-236. 10.1016/j.thromres.2011.03.024.CrossRefPubMed Colaizzo D, Tiscia GL, Bafunno V, et al: Sex modulation of the occurrence of jak2 v617f mutation in patients with splanchnic venous thrombosis. Thromb Res. 2011, 128: 233-236. 10.1016/j.thromres.2011.03.024.CrossRefPubMed
20.
go back to reference Kiladjian JJ, Cervantes F, Leebeek FW, et al: The impact of JAK2 and MPL mutations on diagnosis and prognosis of splanchnic vein thrombosis: a report on 241 cases. Blood. 2008, 111: 4922-4929. 10.1182/blood-2007-11-125328.CrossRefPubMed Kiladjian JJ, Cervantes F, Leebeek FW, et al: The impact of JAK2 and MPL mutations on diagnosis and prognosis of splanchnic vein thrombosis: a report on 241 cases. Blood. 2008, 111: 4922-4929. 10.1182/blood-2007-11-125328.CrossRefPubMed
21.
go back to reference Austin SK, Lambert JR: The JAK2 V617F mutation and thrombosis. Br J Haematol. 2008, 143: 307-320. 10.1111/j.1365-2141.2008.07258.x.CrossRefPubMed Austin SK, Lambert JR: The JAK2 V617F mutation and thrombosis. Br J Haematol. 2008, 143: 307-320. 10.1111/j.1365-2141.2008.07258.x.CrossRefPubMed
22.
go back to reference Vannucchi AM: JAK2 mutation and thrombosis in the myeloproliferative neoplasms. Curr Hematol Malig Rep. 2010, 5: 22-28. 10.1007/s11899-009-0038-x.CrossRefPubMed Vannucchi AM: JAK2 mutation and thrombosis in the myeloproliferative neoplasms. Curr Hematol Malig Rep. 2010, 5: 22-28. 10.1007/s11899-009-0038-x.CrossRefPubMed
23.
go back to reference Xavier SG, Gadelha T, Pimenta G, et al: JAK2V617F mutation in patients with splanchnic vein thrombosis. Dig Dis Sci. 2010, 55: 1770-1777. 10.1007/s10620-009-0933-y.CrossRefPubMed Xavier SG, Gadelha T, Pimenta G, et al: JAK2V617F mutation in patients with splanchnic vein thrombosis. Dig Dis Sci. 2010, 55: 1770-1777. 10.1007/s10620-009-0933-y.CrossRefPubMed
24.
go back to reference Orr DW, Patel RK, Lea NC, et al: The prevalence of the activating JAK2 tyrosine kinase mutation in chronic porto-splenomesenteric venous thrombosis. Aliment Pharmacol Ther. 2010, 31: 1330-1336. 10.1111/j.1365-2036.2010.04299.x.CrossRefPubMed Orr DW, Patel RK, Lea NC, et al: The prevalence of the activating JAK2 tyrosine kinase mutation in chronic porto-splenomesenteric venous thrombosis. Aliment Pharmacol Ther. 2010, 31: 1330-1336. 10.1111/j.1365-2036.2010.04299.x.CrossRefPubMed
25.
go back to reference Wüthrich RP, Cicvara-Muzar S, Booy C, Maly FE: Heterozygosity for the factor V Leiden (G1691A) mutation predisposes renal transplant recipients to thrombotic complications and graft loss. Transplantation. 2001, 72: 549-550. 10.1097/00007890-200108150-00037.CrossRefPubMed Wüthrich RP, Cicvara-Muzar S, Booy C, Maly FE: Heterozygosity for the factor V Leiden (G1691A) mutation predisposes renal transplant recipients to thrombotic complications and graft loss. Transplantation. 2001, 72: 549-550. 10.1097/00007890-200108150-00037.CrossRefPubMed
Metadata
Title
Splanchnic vein thrombosis following renal transplantation: a case report
Authors
Erhan Tatar
Adam Uslu
Ahmet Aykas
Funda Tasli
Ozgur Oztekin
Gulsum Akgun Cagliyan
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Nephrology / Issue 1/2013
Electronic ISSN: 1471-2369
DOI
https://doi.org/10.1186/1471-2369-14-161

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