Polycythemia vera with acute coronary syndrome and bleeding as initial presentation: A case report and literature review

Q4 Medicine

Radiology Case Reports Pub Date : 2024-11-22 DOI:10.1016/j.radcr.2024.10.109

Rabia Iqbal MBBS , Aemen Shafqat Bazaz MBBS , Ahmad Taimoor Bajwa MBBS , Hnin Nadi Linn MD , Nyan Linn Htet MD , Sabrin Marowa MD , Asmat Ullah MD

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引用次数: 0

Abstract

Polycythemia vera (PV) is a chronic myeloproliferative disorder characterized by increased red blood cell mass, leading to a heightened risk for thrombosis and hemorrhage. While thrombotic complications such as stroke, deep vein thrombosis, and pulmonary embolism are commonly associated with PV, coronary artery syndromes, as the initial presentation, are rare. Here, we present the case of a 73-year-old male who presented with severe chest pain and was diagnosed with non-ST–elevation myocardial infarction (NSTEMI). During his hospitalization, the patient experienced spontaneous psoas muscle hemorrhage, which prompted further investigation. Laboratory workup revealed elevated hemoglobin levels and a positive JAK2 V617F mutation, confirming a diagnosis of polycythemia vera. This case highlights the importance of considering myeloproliferative disorders in patients with atypical thrombotic and hemorrhagic events. It emphasizes the need for early diagnosis and appropriate treatment to optimize patient outcomes.

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以急性冠状动脉综合征和出血为首发症状的多血症：病例报告和文献综述

多发性红细胞增多症（PV）是一种慢性骨髓增生性疾病，其特点是红细胞增多，导致血栓形成和出血的风险增加。虽然中风、深静脉血栓和肺栓塞等血栓并发症通常与红细胞增多症有关，但以冠状动脉综合征为首发症状的病例却很少见。在此，我们介绍了一例 73 岁男性患者的病例，他因剧烈胸痛就诊，被诊断为非 ST 段抬高型心肌梗死（NSTEMI）。住院期间，患者出现自发性腰肌出血，这促使他接受进一步检查。实验室检查发现血红蛋白水平升高，JAK2 V617F 突变阳性，确诊为多发性红细胞症。本病例强调了在非典型血栓和出血事件患者中考虑骨髓增生性疾病的重要性。它强调了早期诊断和适当治疗的必要性，以优化患者的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Radiology Case Reports Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

1.10

自引率

0.00%

发文量

1074

审稿时长

30 days

期刊介绍： The content of this journal is exclusively case reports that feature diagnostic imaging. Categories in which case reports can be placed include the musculoskeletal system, spine, central nervous system, head and neck, cardiovascular, chest, gastrointestinal, genitourinary, multisystem, pediatric, emergency, women''s imaging, oncologic, normal variants, medical devices, foreign bodies, interventional radiology, nuclear medicine, molecular imaging, ultrasonography, imaging artifacts, forensic, anthropological, and medical-legal. Articles must be well-documented and include a review of the appropriate literature.