Rai Praveer, Kumar Pankaj, Mishra Swapnil, Aggarwal Rakesh
Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226 014, India.
Indian J Gastroenterol. 2016 Sep;35(5):366-371. doi: 10.1007/s12664-016-0691-7. Epub 2016 Sep 16.
Hepatic venous outflow tract obstruction (HVOTO) and extrahepatic portal venous obstruction (EHPVO) are important causes of portal hypertension and related complications in India. Both these conditions result from splanchnic venous thrombosis. In recent years, a V617F somatic mutation in Janus kinase 2 (JAK2) gene which is highly specific for myeloproliferative disorders has been detected in 40 % to 50 % and 30 % to 35 % of Western patients with HVOTO and EHPVO, respectively. However, data on this mutation in these conditions from Asian countries are limited.
We looked for JAK2 V617F mutation in Indian patients with HVOTO (n = 40, median age 31 [range 17-51] years, 21 female) and EHPVO (n = 50, median age 23 [15-70] years, 25 female) by using two separate methods. Both the methods involved polymerase chain reaction using allele-specific primers. Positive results on one or both of these techniques were confirmed using DNA sequencing.
None of the 40 patients with HVOTO and only 1 of 50 patients with EHPVO was found to have JAK2 V617F mutation. In the one patient who was found to have this mutation, both the PCR methods and DNA sequencing showed positive results.
Hypercoagulability associated with JAK2 V617F mutation and associated chronic myeloproliferative disorders was not a major cause of HVOTO and EHPVO in this population.
肝静脉流出道梗阻(HVOTO)和肝外门静脉梗阻(EHPVO)是印度门静脉高压及其相关并发症的重要病因。这两种情况均由内脏静脉血栓形成所致。近年来,分别在40%至50%的西方HVOTO患者和30%至35%的西方EHPVO患者中检测到了对骨髓增殖性疾病具有高度特异性的Janus激酶2(JAK2)基因V617F体细胞突变。然而,来自亚洲国家的关于这些疾病中该突变的数据有限。
我们采用两种不同方法,在印度HVOTO患者(n = 40,中位年龄31岁[范围17 - 51岁],女性21例)和EHPVO患者(n = 50,中位年龄23岁[15 - 70岁],女性25例)中寻找JAK2 V617F突变。两种方法均涉及使用等位基因特异性引物的聚合酶链反应。使用DNA测序对这两种技术中一项或两项的阳性结果进行确认。
40例HVOTO患者中无一例被发现有JAK2 V617F突变,50例EHPVO患者中仅有1例被发现有该突变。在发现有此突变的1例患者中,两种PCR方法及DNA测序均显示阳性结果。
与JAK2 V617F突变及相关慢性骨髓增殖性疾病相关的高凝状态并非该人群中HVOTO和EHPVO的主要病因。