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%
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