Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 16, 2021; 9(8): 1871-1876
Published online Mar 16, 2021. doi: 10.12998/wjcc.v9.i8.1871
Gastroesophageal varices in a patient presenting with essential thrombocythemia: A case report
Jian-Bo Wang, Yang Gao, Jun-Wei Liu, Mu-Gen Dai, Shang-Wen Yang, Bin Ye
Jian-Bo Wang, Jun-Wei Liu, Mu-Gen Dai, Shang-Wen Yang, Bin Ye, Department of Gastroenterology, Lishui Hospital of Zhejiang University, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Central Hospital, Lishui 323000, Zhejiang Province, China
Yang Gao, Department of Radiology, Lishui Hospital of Zhejiang University, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Central Hospital, Lishui 323000, Zhejiang Province, China
Author contributions: Wang JB and Gao Y collected and analyzed the data, wrote the manuscript; Liu JW, Dai MG and Yang SW collected and analyzed the data; Ye B designed the study and analyzed the data; all authors have read and approved the manuscript for submission.
Informed consent statement: Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
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: Bin Ye, MD, Chief Doctor, Department of Gastroenterology, Lishui Hospital of Zhejiang University, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Central Hospital, No. 289 Kuocang Road, Lishui 323000, Zhejiang Province, China. 1710469@tongji.edu.cn
Received: September 16, 2020
Peer-review started: September 16, 2020
First decision: December 21, 2020
Revised: January 3, 2021
Accepted: January 28, 2021
Article in press: January 28, 2021
Published online: March 16, 2021
Abstract
BACKGROUND

Gastroesophageal varices are a rare complication of essential thrombocythemia (ET). ET is a chronic myeloproliferative neoplasm (MPN) characterized by an increased number of blood platelets.

CASE SUMMARY

A 46-year-old woman, who denied a history of liver disease, was admitted to our hospital on presentation of hematemesis. Laboratory examination revealed a hemoglobin level of 83 g/L, and a platelet count of 397 × 109/L. The appearance of gastric and esophageal varices with red colored signs as displayed by an urgent endoscopy was followed by endoscopic variceal ligation and endoscopic tissue adhesive. Abdominal computed tomography revealed cirrhosis, marked splenomegaly, portal vein thrombosis and portal hypertension. In addition, bone marrow biopsy and evidence of mutated Janus kinase 2, substantiated the onset of ET. The patient was asymptomatic with regular routine blood testing during the 6-mo follow-up period. Therefore, in this case, gastroesophageal varices were induced by ET.

CONCLUSION

MPN should be given considerable attention when performing differential diagnoses in patients with gastroesophageal varices. An integrated approach such as laboratory tests, radiological examination, and pathological biopsy, should be included to allow optimal decisions and management.

Keywords: Gastroesophageal varices, Essential thrombocythemia, Non-cirrhotic portal hypertension, Endoscopic variceal ligation, Endoscopic tissue adhesive, Case report

Core Tip: Gastroesophageal varices are a rare complication of essential thrombo-cythemia (ET). This report describes a 46-year-old woman who presented with ET-induced esophageal and gastric varies. ET is a chronic myeloproliferative neoplasm, which should be given considerable attention when performing differential diagnoses in patients with gastroesophageal varices, in order to allow optimal decisions and management.