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Peripheral neuropathy associated with polycythemia vera

J J Poza1, A M Cobo, J F Martí-Massó

  • 1Servicio de Neurología, Hospital Nuestra Señora de Aránzazu, San Sebastián.

Neurologia (Barcelona, Spain)
|October 1, 1996
PubMed
Summary
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Peripheral neuropathy is common in polycythemia vera patients, often presenting as sensory axonal polyneuropathy. This condition likely results from blood viscosity and platelet issues, impacting nerve function.

Area of Science:

  • Neurology
  • Hematology

Background:

  • Polycythemia vera is a myeloproliferative neoplasm characterized by increased red blood cell mass.
  • Peripheral neuropathy can be a complication of various systemic diseases.

Purpose of the Study:

  • To investigate the prevalence and characteristics of peripheral neuropathy in patients with polycythemia vera.
  • To differentiate neuropathy related to polycythemia vera from other causes.

Main Methods:

  • Prospective clinical and electrophysiological study of 28 polycythemia vera patients.
  • Exclusion of other potential causes of neuropathy.
  • Clinical examination, nerve conduction studies, and evoked potential testing (somatosensory and brain-stem).

Main Results:

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  • 46% of patients showed clinical signs of polyneuropathy.
  • 71% had abnormal nerve conduction indexes, indicating a sensory axonal polyneuropathy.
  • Evoked potential studies revealed delays in somatosensory and brain-stem pathways in a significant number of patients.
  • No correlation found between neuropathy and patient demographics, disease duration, hematocrit, or platelet count.

    • Conclusions:

    • A high proportion of polycythemia vera patients exhibit subclinical or clinical peripheral neuropathy.
    • The neuropathy is predominantly sensory and axonal, likely secondary to ischemic mechanisms caused by increased blood viscosity and platelet dysfunction.
    • Electrophysiological testing is crucial for detecting neuropathy in this patient population.