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논문분류	춘계학술대회 초록집
제목	Renal Infarction Revealing JAK2 V617F-Mutated Essential Thrombocythemia and Coronary Artery Disease
저자	Seunghye Lee
출판정보	2025; 2025(1):
키워드	Coronary artery disease, Essential thrombocythemia, JAK2 V617F mutation, Renal infarction, Thrombosis
초록	Renal infarction is a rare and often underdiagnosed cause of acute flank pain. While thromboembolic events are well-known complications of myeloproliferative neoplasms such as essential thrombocythemia (ET), renal infarction as an initial manifestation is uncommon. Here, we report a case of renal infarction associated with ET and concomitant coronary artery disease (CAD). A 43-year-old woman presented with sudden-onset, severe left flank pain. Two month prior, she had visited a clinic for chest discomfort. A week earlier, she had been treated for a cold at a private clinic, where thrombocytosis was detected. She had a 10-year smoking history (1 pack/day) and consumed soju (2 bottles per sitting, 5 times/month) for 20 years. Her blood pressure was 157/101 mmHg, heart rate 73 bpm, and left costovertebral angle tenderness was noted. Laboratory tests showed leukocytosis (17,610/µL), thrombocytosis (660 × 10³/µL), elevated lactate dehydrogenase (435 IU/L), serum creatinine 0.69 mg/dL, proteinuria, and 0–4 red blood cells/high-power field in urine. Computed tomography revealed multifocal left renal infarctions (Fig. 1). Anticoagulation with low-molecular-weight heparin and warfarin was initiated. Autoimmune markers were negative, and homocysteine levels were normal. Bone marrow biopsy showed megakaryocytic hyperplasia, and JAK2 V617F mutation confirmed ET. Cardiac evaluation revealed stable angina, right coronary artery ischemia, and chronic total occlusion of the proximal left anterior descending artery. She underwent percutaneous coronary intervention and was discharged on aspirin, warfarin, hydroxyurea, clopidogrel, and rosuvastatin. Smoking cessation and alcohol reduction were advised to lower thrombotic risk. At the 2-month follow-up, platelet count had decreased to 443 × 10³/µL, and serum creatinine was 0.55 mg/dL. This case highlights ET as a potential cause of renal infarction and CAD, requiring multidisciplinary management, including lifestyle modifications.
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