{
  "abstract": "Splanchnic vein thrombosis (SVT) is a rare, life-threatening condition that is often associated with cirrhosis, pancreatic malignancy and thrombophilia. Myeloproliferative neoplasms are under-recognised causes, posing diagnostic challenges. In this case, we present a male in his late 20s with a history of unprovoked pulmonary embolism and portal/splenic vein thrombosis, on indefinite anticoagulation therapy presenting 3 years later due to abdominal pain. Imaging revealed cirrhosis, cavernous transformation of the main portal vein and splenomegaly. These findings and a prior negative hypercoagulability workup prompted haematology consultation. Bone marrow biopsy confirmed primary myelofibrosis (PMF), demonstrating 90% cellularity, megakaryocytic hyperplasia, MF-3 fibrosis and calreticulin (CALR) mutation. This case underscores PMF as a treatable cause of SVT in young patients with recurrent thrombosis and highlights the consequences of diagnostic inertia, as marked thrombocytosis at initial presentation was overlooked. When Janus Kinase 2 (JAK2) is negative, CALR testing should be pursued to enable early diagnosis and targeted therapy.",
  "authors": [
    {
      "affiliations": [
        "Internal Medicine, SSM Health Saint Louis University Hospital, St. Louis, Missouri, USA"
      ],
      "name": "Brian Abboud"
    },
    {
      "affiliations": [
        "Internal Medicine, SSM Health Saint Louis University Hospital, St. Louis, Missouri, USA"
      ],
      "name": "Isra Taha"
    },
    {
      "affiliations": [
        "School of Medicine, SSM Health Saint Louis University Hospital, St. Louis, Missouri, USA"
      ],
      "name": "Ziniya Shah"
    },
    {
      "affiliations": [
        "Internal Medicine, SSM Health Saint Louis University Hospital, St. Louis, Missouri, USA"
      ],
      "name": "Allison Shildt"
    },
    {
      "affiliations": [
        "Division of Hematology-Oncology and Bone Marrow Transplant, SSM Health Saint Louis University Hospital, St. Louis, Missouri, USA"
      ],
      "name": "Ariel Rischall"
    },
    {
      "affiliations": [
        "Internal Medicine, SSM Health Saint Louis University Hospital, St. Louis, Missouri, USA"
      ],
      "name": "Joseph Wheeler"
    }
  ],
  "title": "Myeloproliferative neoplasm as a cause of splanchnic vein thrombosis",
  "uid": "39ce69b3-9914-51f4-b13c-d051a42a4098"
}