ArticleAnnals of medicine and surgery (2012)2026
JAK2-positive erythrocytosis presenting with left occipital infarction in a young adult: a case report from a resource‑limited setting.
Article in Annals of medicine and surgery (2012), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Polycythemia-spectrum disorders carry thrombotic risk; in young adults, stroke may be the first manifestation. We report a young male with JAK2-positive erythrocytosis highly suggestive of polycythemia vera, emphasizing diagnostic framing and pragmatic management in a resource-limited setting. Case presentation: A 35-year-old former smoker presented with three days of right-sided body tingling. Examination was nonfocal. Laboratory testing revealed hemoglobin 19.3 g/dL and hematocrit 61.4%. Noncontrast computed tomography obtained on Day 3 showed a small, ill-defined hypodensity in the left occipital lobe, consistent with acute infarction. JAK2 V617F mutation was detected; erythropoietin (EPO) was within the normal range (20 mU/L). In the absence of marrow histology and subnormal EPO, the working diagnosis was JAK2-positive erythrocytosis with a syndrome highly suggestive of PV. Treatment comprised phlebotomy, low-dose aspirin, hydroxyurea, and statin therapy. Discussion: The case highlights pragmatic stroke evaluation in a young adult, where MRI and comprehensive vascular work-up were not fully available. We discuss pathophysiology, differential diagnoses, and how resource constraints impact certainty and generalizability. Conclusion: Ischemic stroke can be the initial presentation of JAK2-positive erythrocytosis consistent with polycythemia vera. Careful framing of diagnostic certainty, early hematocrit control, antithrombotic therapy, and risk-factor optimization are key, especially where resources are limited.
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