Uncontrolled Polycythemia Vera: Case 1

August 2014

• A 67-year-old female is diagnosed PV after complaining of fatigue
• Physical Exam was unremarkable
• CBC:
  • HCT, 48%
  • WBC, 12,100/μL
  • Platelets, 603,000/μL
• Mutation testing: JAK2 V617F-positive
• The patient was started on treatment with low-dose aspirin and hydroxyurea 500 mg/day
• Her symptoms resolved within 3 months

February 2016

• She now complains of left upper quadrant pain
• For 1.5 years, the patient was maintained on treatment; however, for the past 9 months her hematocrit has risen to 48% and she has required 4 phlebotomies in last 6 months
• Hydroxyurea was increased from 500 mg to 1,000 mg daily
• Physical Exam: remarkable for splenomegaly

August 2016

• Physical Exam: still remarkable for splenomegaly, slightly smaller
• HCT 47.5%