Macroscopic Hematuria as the Initial Presentation of Polycythemia Vera.

Autor:	Oliveira SCS; Neurological Surgery, Federal University of Ceará, Sobral, BRA., Santos LTR; Internal Medicine, Federal University of Ceará, Sobral, BRA., Esmeraldo MA; Neuroscience, Federal University of Ceará, Sobral, BRA., Neto OPO; Internal Medicine, Federal University of Ceará, Sobral, BRA., da Ponte MF; Internal Medicine, Federal University of Ceará, Sobral, BRA.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2020 Oct 05; Vol. 12 (10), pp. e10800. Date of Electronic Publication: 2020 Oct 05.
DOI:	10.7759/cureus.10800
Abstrakt:	Polycythemia vera (PV) is a chronic myeloproliferative neoplasm (CMN) characterized by the accumulation of red blood cells, granulocytes and platelets in the peripheral blood. The main complications of PV are an increased risk of thrombosis, bleeding and transformation to myelodysplasia or acute leukemia. The authors report the case of a 28-year-old man with a complaint of macroscopic hematuria, low back pain and edema of the left arm associated with elevated hemoglobin, hematocrit and lactic dehydrogenase, leukocytosis and increased renal volume. Computed tomography of the chest and abdomen with contrast showed venous ectasia in the left upper limb and thrombosis of the right renal vein with extension to the inferior vena cava. A diagnosis of PV was confirmed by the presence of the JAK2 mutation and a bone marrow biopsy that showed panmyelosis. The patient was anticoagulated and treatment for PV was started with aspirin, phlebotomy and hydroxyurea. Then, the patient was discharged for outpatient follow-up with a hematologist. The case emphasizes the importance of clinical suspicion for atypical presentation of the disease in an unusual age range and of adequate etiological investigation of thrombosis in unusual sites. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2020, Oliveira et al.)
Databáze:	MEDLINE
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