JAK-2 positive Polycythemia Vera in a Rheumatoid Arthritis patient: A case Report and literature review

Abstract

Rheumatoid arthritis is a systemic inflammatory autoimmune disease of unknown etiology that initially presents as a polyarthritis involving the small joints of the hands and feet. As part of its systemic feature, the hematologic system can be affected in RA. The most common hematologic manifestation of RA is normochromic normocytic anemia of chronic disease or anemia from myelosuppression from disease modifying antirheumatic drugs. Polycythemia has been rarely reported in association with RA, as most cases of polycythemia occurring in the setting of autoimmune diseases were seen with diseases other than RA. Given the association of RA with accelerated atherosclerosis and an adverse cardiovascular outcome, the occurrence of polycythemia could increase the risk of a cardiovascular event. A rare case of JAK-2 positive polycythemia vera occurring in a 42-year-old patient with established RA is presented in this report to heighten the index of suspicion amongst clinicians and also to highlight the management plan.