Clinical characteristics of stroke patients with essential thrombocytosis according to JAK2 mutation

초록

Backgrounds and Purpose : Essential thrombocytosis is a rare disorder and usually presents with bleeding, headache, dizziness and splenomegaly. JAK2 mutation is one of the common causes of essential thrombocytosis. However, the clinical features of stroke patients with essential thrombocytosis, especially related to JAK2 mutation, remains unclear. Methods: We selected the patients with essential thrombocytosis from our stroke registry from 2005 to 2014 and analyzed the demographic and laboratory findings according to JAK2 mutation. Results: Among 7857 patients in stroke registry, only 40 (0.5%) patients had the essential thrombocytosis (mean age 66.8±11.2, male 18). Mean platelet count was 648±267 *103/μL and 18 (45%) had the JAK2 mutation. Twenty one patients (52.5%) had the cryptogenic stroke etiology and cardioembolism and transient ischemic attack were also frequently observed (17.5% and 15%, respectively). Three (7.5%) patients died within 3 months of stroke onset. There was no difference in the demographic profile and the frequency of hypertension, diabetes mellitus, and dyslipidemia between the patients with JAK2 mutation and those without. The platelet counts were not different either between two groups. The patients without JAK2 mutation had more frequent accompanying cancer than those with JAK2 mutation (41% vs. 11%, P=0.04). Conclusion: Our results suggest that the essential thrombocytosis is rare condition in stroke population and is more commonly detected in the cryptogenic stroke. If a stroke patient with essential thrombocytosis had no JAK2 mutation, the possibility of hidden malignancy might be considered.