Polycythemia Vera leading to Jaundice and Marantic Endocarditis, A Case Presentation

Polycythemia vera is an uncommon myeloproliferative neoplasm characterized by the abnormal proliferation and maturation of hematopoietic stem or progenitor cells. It also known as one BCR-ABL1 negative neoplasms, along with essential thrombocythemia myelofibrosis. Incomparison to myelofibrosis, polycythemia driven JAK2 mutations, specifically JAK2V617F, activating mutation encoding a tyrosine kinase [1]. This variant correlated increased erythropoiesis myelopoiesis, lower platelet count, higher incidence splenomegaly, pruritus thrombotic events. A 58-year-old male presented Emergency Department complaining painless jaundice. Comprehensive blood count revealed elevated white cell hemoglobin/ hematocrit, platelets. Total bilirubin was at 30.3g/dL, direct 27g/dL. Jak- 2 positive, which suggested diagnosis although atypical given his An Erythropoietin level found be less than 1, suggesting primary cause vera. In addition, patient have marantic nonbacterial endocarditis on transesophageal echocardiogram. Patient treated aspirin prevent events, hydroxyurea cholestyramine. The patient’s physical examination profuse jaundice 27g/dL typically does not correlate presentation Through further workup, did demonstrate hemolytic intrahepatic causes, both intrinsic extrinsic liver, would explained presentation. led conclusion that most likely caused