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[Primary polycythaemia vera in the elderly]

F Gabriel Botella1, M Labiós Gómez, J Sempere Montés

  • 1Servicio de Medicina Interna, Hospital Clínico Universitario de Valencia.

Anales De Medicina Interna (Madrid, Spain : 1984)
|May 15, 1998
PubMed
Summary
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An 86-year-old woman experienced sudden left hand paralysis due to polycythemia vera (PV). Phlebotomy resolved symptoms, highlighting PV

Area of Science:

  • Hematology
  • Neurology
  • Internal Medicine

Background:

  • Polycythemia vera (PV) is a myeloproliferative neoplasm characterized by increased red blood cell mass.
  • PV can lead to hyperviscosity and thrombotic complications, affecting various organ systems.

Observation:

  • An 86-year-old female presented with acute left hand paralysis, hypertension, and dizziness.
  • Investigations revealed erythrocytosis, leukocytosis, thrombocytosis, elevated red cell volume, and increased blood viscosity with normal O2 saturation.

Findings:

  • The patient was diagnosed with polycythemia vera (PV).
  • Following phlebotomy, her left hand paralysis resolved within 24 hours, with functional recovery.
  • Diagnostic criteria by the Polycythemia Vera Study Group (PVSG) were analyzed.

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Implications:

  • This case underscores the potential for neurological manifestations in PV due to hyperviscosity.
  • Treatment options for PV, including phlebotomy, chemotherapy (hydroxyurea, pipobroman), erythropheresis, interferon, and aspirin, carry distinct risks.
  • Optimal PV management likely involves a personalized combination of therapies tailored to disease phase and patient factors.