BackgroundPrior thrombosis is a well-established risk factor for re-thrombosis in polycythemia vera and essential thrombocythemia but scarce data are available on the rate of re-thrombosis and the optimal strategy for prevention of recurrence.

Summary.  Background:  Thrombosis of splanchnic or cerebral veins is a typical manifestation of polycythemia vera (PV) or essential thrombocythemia (ET). The recently identified Janus kinase 2 (JAK2) V617F somatic mutation is closely related to chronic myeloproliferative disorders (CMD). Objective:  To assess the incidence of the JAK2 V617F mutation among patients with splanchnic or cerebral venous thrombosis with or without overt CMD. Patients and methods:  We searched for the mutation in 139 adult patients (> 18 years old) with thrombosis of hepatic veins (HVT, n = 15), or extrahepatic portal vein (PVT) and/or mesenteric vein (MVT) (n = 79), or cerebral veins (CVT, n = 45). Only 19 patients fulfilled criteria for diagnosis of PV (n = 8) or ET (n = 11) at the time of thrombosis: four had HVT, 11 PVT and/or MVT, and four CVT. Results:  The JAK2 V617F mutation was found in 94.7% [95% CI 75.3–99.0] of the patients with overt CMD at the time of thrombosis, in 21.5% (95% CI 13.8–31.7) of the patients with abdominal venous thrombosis and without overt CMD, and in 4.8% (95% CI 1.3–16.1) of the patients with CVT and without overt CMD. Among the patients without overt CMD or thrombophilia and with unprovoked thrombosis, 29.4% (95% CI 16.8–46.1) with splanchnic venous thrombosis and 42.8% (95% CI 24.4–63.4) with PVT had the JAK2 V617F mutation. Conclusions:  A substantial proportion of patients with splanchnic venous thrombosis and a small, but significant, number of patients with CVT can be recognized as carriers of the JAK2 V617F mutation in the absence of overt signs of CMD. The clinical significance of such findings deserves further investigation.

Nineteen women (21AE5%, 95% CI 14AE2-31AE2) had a pregnancyor a puerperium-related recurrent VTE, with an overall rate of 12AE2% (95% CI 7AE9-18AE3) among the 155 recorded pregnancies; recurrences were 16 DVTs of the legs, 1 DVT with PE, and 2 PE. Nine recurrences occurred during pregnancy (5AE8%, 95% CI 3AE0-10AE6) and 10 during puerperium (8AE3%, 95% CI 4AE5-14AE6); five pregnancy-and six puerperium-related recurrent VTE occurred during the first pregnancy after the first VTE. Pregnancy-related Recurrent Venous Thromboembolism

below the mean BMD in young adults (20-40 years old) of the same gender. The Z-score denotes how many SDs a person's BMD is above or below the mean BMD in the matched population. The coefficient of variation (CV) for the areal BMD measurements ranged from 0.5 to 3%, depending on application.Peripheral quantitative computerized tomography. The volumetric BMD (g/cm 3 ) of the nondominant distal arm (the radial bone) and distal leg (the tibial bone) was measured by pQCT (XCT-2000, Stratec Medizintechnik, GmbH, Pforzheim, Germany). The pQCT-device was calibrated once a week using a standard phantom and once every 30 day using a cone phantom provided by the manufacturer. A 2-mm-thick single tomographic slice was scanned with a voxel size of 0.50 mm. The cortical volumetric BMD was measured using a scan through the diaphysis at 25% of the bone length in the proximal direction of the distal end of the radial and tibial bones, respectively. Trabecular volumetric BMD was measured using a scan through the metaphysis at 4% of the bone length in the proximal direction of the distal end of the radial and tibial bones, respectively. All pQCT analyses were performed by a single technician using a single pQCT device. The CVs were less than 1% for all pQCT measurements, as previously reported [25].Statistics. Paired two-sided t-tests and Wilcoxon signed rank tests were performed to evaluate differences over time in each group. Unpaired twosided t-tests and Mann-Whitney U were performed to compare CML patients and controls. Fischer's exact test was used to compare the number of individuals with hyperparathyroidism in 2007 and 2011, respectively. A P < 0.05 was considered statistically significant. All data shown are mean values ± standard error of mean (SEM) unless otherwise stated.

A multicenter retrospective analysis was performed to estimate the frequency of thrombosis and hemorrhage after surgical procedures in patients with polycythemia vera (PV) and patients with essential thrombocythemia (ET