Cao YY, Cao J, Bi ZJ, Xu SB, Liu CC. Hemorrhagic transformation after acute ischemic stroke caused by polycythemia vera: Report of two case. World J Clin Cases 2021; 9(25): 7551-7557 [PMID: 34616825 DOI: 10.12998/wjcc.v9.i25.7551]
Corresponding Author of This Article
Chen-Chen Liu, MD, Doctor, Lecturer, Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430000, Hubei Province, China. liuchenchen8807@126.com
Research Domain of This Article
Neurosciences
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Sep 6, 2021; 9(25): 7551-7557 Published online Sep 6, 2021. doi: 10.12998/wjcc.v9.i25.7551
Hemorrhagic transformation after acute ischemic stroke caused by polycythemia vera: Report of two case
Ya-Yun Cao, Jie Cao, Zhua-Jin Bi, Sha-Bei Xu, Chen-Chen Liu
Ya-Yun Cao, Jie Cao, Zhua-Jin Bi, Sha-Bei Xu, Chen-Chen Liu, Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei Province, China
Ya-Yun Cao, Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan 430000, Hubei Province, China
Author contributions: Cao YY acquired the data and drafted the manuscript; Cao J acquired and analyzed the data; Bi ZJ analyzed and interpreted the imaging findings; Xu SB helped revise the manuscript; Liu CC designed the study and revised the manuscript; all authors have read and approved the manuscript.
Informed consent statement: Writtern informed consent was obtained from the patients for publication of this case report.
Conflict-of-interest statement: The authors declare no conflict of interest for this manuscript.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chen-Chen Liu, MD, Doctor, Lecturer, Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430000, Hubei Province, China. liuchenchen8807@126.com
Received: February 28, 2021 Peer-review started: February 28, 2021 First decision: July 5, 2021 Revised: July 12, 2021 Accepted: July 19, 2021 Article in press: July 19, 2021 Published online: September 6, 2021
Abstract
BACKGROUND
Polycythemia vera (PV) is a chronic myeloproliferative disorder characterized by an increase in red blood cells in the peripheral blood. Previous work has reported the occurrence of thrombosis or hemorrhage arising in the cerebral vasculature secondary to PV. However, hemorrhagic transformation after PV-associated acute ischemic stroke has not been previously described.
CASE SUMMARY
We herein present two cases of PV where hemorrhagic transformation occurred after an acute ischemic stroke. Case 1 was a 57-year-old woman with a history of hypertension who was admitted for left-sided weakness. Case 2 was a 68-year-old man who was admitted for a 10-d sudden left arm weakness. Imaging examinations for the two patients revealed hemorrhagic transformation after acute ischemic stroke. Both patients had JAK-2-V617F mutation and received antiplatelet therapy. Both of them had a good prognosis during the follow-up.
CONCLUSION
This report suggested that hemorrhagic transformation may occur in acute ischemic stroke caused by PV. Antiplatelet drugs do not seem to influence the long-term outcomes in such patients. Future research should focus on establishing a standard antiplatelet treatment strategy for this condition.
Core Tip: Polycythemia vera (PV) is a rare, myeloproliferative disorder. Ischemic stroke is the most frequent neurologic manifestation of PV. However, hemorrhagic transformation after acute ischemic stroke caused by PV has not been previously reported. Here, we present two patients with PV who developed hemorrhagic transformation after sustaining an acute ischemic stroke. Antiplatelet drugs did not lead to poor long-term outcomes in our patients.
