A 45-year-old has persistent erythrocytosis, low erythropoietin, a JAK2 exon 12 variant and marrow panmyelosis. There is no previous thrombosis. What

Question

A 45-year-old has persistent erythrocytosis, low erythropoietin, a JAK2 exon 12 variant and marrow panmyelosis. There is no previous thrombosis. What is the foundational thrombosis-prevention strategy?

Accepted Answer

Diagnose polycythaemia vera, use venesection to maintain haematocrit below 0.45 and give low-dose aspirin if not contraindicated

Answer

Use full-dose anticoagulation across differing thrombosis and bleeding histories

Answer

Observe before commencing haematocrit control because JAK2 V617F is the principal recognised polycythaemia-vera variant

Answer

Treat with iron replacement until the haematocrit normalises

Answer

Use splenectomy as first-line treatment because marrow panmyelosis cannot be medically controlled

JAK2 Exon 12 PV — RACP Adult Medicine MCQ

A 45-year-old has persistent erythrocytosis, low erythropoietin, a JAK2 exon 12 variant and marrow panmyelosis. There is no previous thrombosis. What is the foundational thrombosis-prevention strategy?