Polycythemia vera, clusters of vascular endothelium
Journal Title: Αρχεία Ελληνικής Ιατρικής - Year 2011, Vol 28, Issue 4
Abstract
A 67-year-old man presented to the Outpatient Department because of severe headache, dizziness, weakness, and pruritus. Headache and giddiness were started six months before his admission. The administration of medication did not improve the symptoms. Vertigo and tinnitus were added and the ENT examination revealed Meniere’s syndrome. The patient also complained of intense itching, especially after warm bath; thus, bathing with warm water was avoided. He was treated with potent antihistaminic agents (cetirizine and loratadine) without any improvement. His past medical history included only a duodenal ulcer two years ago. Physical examination revealed mild hypertension (160/95 mmHg), while the pulse rate was 67/min and the respiratory rate was 18/min. A palpable non-tender spleen of 4 cm below the costal margin and a mild hepatomegaly (2 cm below the right costal margin) were also found. Hematology tests revealed erythrocytosis (7.1×1012/L) with an increased number of both white cell counts (16.2×109/L, differential count: Neutrophils 62%, lymphocytes 21%, monocytes 3%, eosinophils 4%, basophils 3%, myelocytes 2% and metamyelocytes 5%) and platelet counts (654×109/L). Hemoglobin and hematocrit levels were also high (18.1g/dL and 56.4%, respectively). Slight anisocytosis and polychromatophiliawere observed in peripheral blood smears and in some fields numerous cells as those shown in figure 1. The reticulocyte count was 2.1% and the red blood cells mass was 41 mL/kg. Serum biochemical tests revealed only a moderate hyperuricemia (8.9 g/dL) and increased B12 levels (1,200 pg/mL).
Authors and Affiliations
J. MELETIS, L. PAPAGEORGIOU, V. KARALI, G. KOUTSIKAS, K. PETEVI, Th. DALAGIORGOS, A. KANELLOPOULOS, P. FLEVARI, E. KOUTSI
Keywords
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