Case Overview: A 58-Year-Old Woman With Polycythemia Vera
Prithviraj Bose, MD:We have a 58-year-old woman at The University of Texas MD Anderson Cancer Center presenting with some abdominal pain, dizziness, and headaches; blood pressure is a little elevated, just mildly; a slightly enlarged spleen. She’s never had a clot. Hemoglobin count is elevated at 17.1 g/dL. The white blood cell count is elevated as well, 13.2. The EPO [erythropoietin] level is conspicuously low. Bone marrow shows erythroid hyperplasia, and she has aJAK2mutation.
So here we have a lady who pretty clearly has PV [polycythemia vera]. You see that her hemoglobin count is higher than the WHO [World Health Organization] thresholds. She has a low EPO level. She has aJAK2V617Fmutation. She has a bone marrow that’s typical with the erythroid hyperplasia. She has pancytosis with her white blood cell count being elevated as well, so it’s a pretty clear-cut case of PV.
Transcript edited for clarity.
Case: 58-Year-Old Woman Diagnosed With Polycythemia Vera
November 2018
- A 58-year old woman presents to PCP complaining of abdominal pain, dizziness and headaches
- PE: BP 140/85; Splenomegaly ~6 cm below left costal margin
- PMH: No prior history of thrombosis
- Lab values:
- HGB: 17.1 g/dL
- Hct: .50 L/L
- RBC: 71 x 1012/L
- WBC: 13.2 x 109/L
- Serum EPO: 4.1 mU/mL
- Bone Marrow Biopsy: Erythroid hyperplasia
- Cytogenetics: JAK-V617Fmutation
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