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Multiple Pulmonary and Splenic Infarcts Triggered by Acute CMV Infection and Transient Double Antiphospholipid Antibody Positivity in a Patient Carrier for JAK-2 Mutation

Esteve-Valverde E, Bonet-Alvarez M, Baraldes-Farre MA, Alijotas-Reig J

The co-existence of inherited thrombophilia with antiphospholipid antibody (aPL) positivity is not uncommon. This association does not overrule the diagnosis of antiphospholipid syndrome. Infection may present together with transient aPL positivity, usually aCL-IgM isotype. Thus certain infections, virus particularly, may increase “per se” thrombotic risk. Herein, we communicate the case of a 29-year-old man who sought medical attention because of a ten days course left-side abdominal pain, cough, fever, fatigue, arthralgia and mild dyspnoea. The patient was diagnosed of multiple pulmonary and splenic infarcts. Interestingly, laboratory results showed the presence of JAK2- V617F mutation, positive CMV serology, first IgM and IgG further, as well as LA test and aCL-IgM transiently but recurrently positive. The role played by these aPL transiently positive antibodies – laboratory category I – as a trigger in the development of this thrombotic diathesis is being discussed.