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Polycythemia vera presenting with bilateral papilledema: a rare case report
S Parija1, M M Mohapatra, B K Pattnaik
1Department of Ophthalmology and State Referral Eye Hospital, SCB Medical College, Cuttack, Orissa, India. drsuchetaparija@rediffmail.com
Indian Journal of Ophthalmology
|June 27, 2008
Summary
This case highlights a rare association between polycythemia vera and advanced papilledema caused by sagittal sinus thrombosis. The findings underscore the importance of considering hematological disorders in neurological presentations.
Area of Science:
- Neurology
- Hematology
- Ophthalmology
Background:
- Sagittal sinus thrombosis (SST) is a rare cerebrovascular condition.
- Papilledema, often indicative of increased intracranial pressure, requires thorough investigation.
- Polycythemia vera (PV) is a myeloproliferative neoplasm characterized by excessive red blood cell production.
Observation:
- A 45-year-old male presented with headache, vomiting, and blurred vision.
- Ophthalmological exam revealed advanced bilateral papilledema with reduced visual acuity.
- Neuroimaging confirmed SST without infarction or mass, while blood tests showed elevated hemoglobin, packed cell volume, leucocytosis, increased Vitamin B12, and decreased erythropoietin.
Findings:
- The patient was diagnosed with polycythemia vera based on the hematological findings.
- The clinical presentation of advanced papilledema was attributed to SST secondary to PV.
- This represents a rare documented association between PV and SST-induced papilledema.
Implications:
- This case emphasizes the need for a comprehensive diagnostic approach in patients with papilledema, including hematological evaluation.
- Recognizing the link between PV and SST can lead to earlier diagnosis and management of both conditions.
- Further research may elucidate the specific mechanisms linking PV to venous sinus thrombosis.
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