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Kondo H, Watanabe R, Okazaki S, Kuriyama K, Ochi T, Yamada G, Sugiura A, Chiba H, Tsukada A, Taniuchi S, Igarashi T, Kudo M, Harigae H, Fujii H. JAK2 mutation-positive polycythaemia vera associated with IgA vasculitis and nephrotic syndrome: a case report. Mod Rheumatol Case Rep 2020; 4:289-295. [PMID: 33087019 DOI: 10.1080/24725625.2020.1728061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We report a case of polycythaemia vera (PV) associated with IgA vasculitis. A 45-year-old man was admitted for evaluation of abdominal pain and palpable purpura. IgA vasculitis was diagnosed, and oral prednisolone therapy (30 mg/day) was initiated. On day 6, the patient developed left hemiparesis, and magnetic resonance imaging revealed acute cerebral infarction. Bone marrow biopsy results and the identification of a Janus kinase 2 (JAK2) mutation led to the diagnosis of PV. Despite steroid therapy, urine protein levels increased to 15 g/g・Cre. Renal biopsy demonstrated mild mesangial proliferation with IgA deposits, but immunosuppressive therapy was partially effective. This case suggests that PV can be a complication of IgA vasculitis and that preventive measures for thrombosis should be taken in such cases.
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Affiliation(s)
- Hinako Kondo
- Department of Rheumatology, Osaki Citizen Hospital, Osaki, Japan
| | - Ryu Watanabe
- Department of Rheumatology, Osaki Citizen Hospital, Osaki, Japan.,Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Soshi Okazaki
- Department of Rheumatology, Osaki Citizen Hospital, Osaki, Japan
| | - Kaori Kuriyama
- Department of Rheumatology, Osaki Citizen Hospital, Osaki, Japan
| | - Tetsuro Ochi
- Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Gen Yamada
- Department of Nephrology and Endocrinology, Osaki Citizen Hospital, Osaki, Japan
| | - Akira Sugiura
- Department of Nephrology and Endocrinology, Osaki Citizen Hospital, Osaki, Japan
| | - Hiromu Chiba
- Department of Dermatology, Osaki Citizen Hospital, Osaki, Japan
| | - Akira Tsukada
- Department of Dermatology, Osaki Citizen Hospital, Osaki, Japan
| | - Shinji Taniuchi
- Department of Pathology, Osaki Citizen Hospital, Osaki, Japan
| | - Takehiko Igarashi
- Department of Gastroenterology, Osaki Citizen Hospital, Osaki, Japan
| | - Masataka Kudo
- Department of Nephrology and Endocrinology, Osaki Citizen Hospital, Osaki, Japan
| | - Hideo Harigae
- Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroshi Fujii
- Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, Sendai, Japan
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