Prurido como principal sintoma da Policitemia Vera: um relato de caso - Abordagem na Atenção Básica / Itching as the main symptom of Polycythemia Vera: a case report - Approach in Primary Care

Abstract Background Infectious complications of peritoneal dialysis (PD) remain a common cause of catheter loss and discontinuation of PD. Exit site infection (ESI) constitutes a significant risk factor for PD-related peritonitis and determination of predisposing states is relevant. We here present a case of repeat ESI due to Pseudomonas aeruginosa in a PD patient with skin changes in the course of polycythemia vera (PV). Case presentation A 73-year-old PD patient with chronic kidney disease secondary to renal amyloidosis and ankylosing spondylitis, presented to the nephrology unit with signs of ESI. In 2006 he was diagnosed with PV and since then has was successfully treated with hydroxyurea; however, he reported recurrent episodes of developing skin nodules in the course of the disease. Exit site swab yielded Pseudomonas aeruginosa and the infection developed in the ulcerated PV nodule that appeared in exit site 2 weeks earlier. Patient was treated with intraperitoneal amikacin and oral ciprofloxacin, however, due to neurological complications, the treatment had to be interrupted and finally catheter was removed. Similar episode of ESI with Pseudomonas aeruginosa developed in the patient two years earlier and also required catheter removal. Conclusion This is the first case report demonstrating the development of ESI on the polycythemia vera skin lesion in this area. Skin manifestations of PV might be a predisposing factor to ESI in PD patients.

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Neuropsychiatric Derangement by Polycythemia Vera: A Case Report of an Unexpected Disease Presentation and Review of the Literature

Acta Haematologica ◽

10.1159/000516441 ◽

2021 ◽

pp. 1-6

Author(s):

Heleen De Lil ◽

Michelle van Beek ◽

Alexandra Herbers ◽

Ellen van der Holst ◽

Karen Keijsers

Keyword(s):

Case Report ◽

Chronic Disease ◽

Cerebral Infarction ◽

Polycythemia Vera ◽

Neuropsychiatric Symptoms ◽

Unusual Presentation ◽

Review Of The Literature ◽

Remarkable Recovery ◽

Visual Complaints ◽

Underlying Pathophysiology

Cerebral infarction as well as other thromboses, headaches, and visual complaints are well-known symptoms of polycythemia vera. However, chorea and neuropsychiatric disturbances are less recognized consequences of this chronic disease. Whereas chorea is a rare but acknowledged symptom of polycythemia vera, neuropsychiatric symptoms have only sporadically been reported. We depict 2 patients with an unusual presentation of polycythemia vera. Our first patient presented with right-sided hemiballism and psychosis, and the second patient had a long diagnostic trajectory of unexplained chorea. In both cases diagnosis of JAK2 positive polycythemia vera was established, and in both cases remarkable recovery occurred after the initiation of phlebotomies. The underlying pathophysiology of these symptoms has not been clearly elucidated. Because of the unfamiliarity of the link between especially neuropsychiatric symptoms and polycythemia, current reported numbers are probably an underestimation. Benefit of treatment appears to be large. We seek to create more awareness among physicians about this phenomenon.

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Sulco Perineal: Uma Anomalia Congénita Rara

Acta Médica Portuguesa ◽

10.20344/amp.7645 ◽

2016 ◽

Vol 29 (10) ◽

pp. 670 ◽

Cited By ~ 2

Author(s):

Manuel Barbosa ◽

Nuno Alves ◽

Natacha Fontes

Keyword(s):

Primary Care ◽

Case Report ◽

Physical Examination ◽

Anorectal Malformation ◽

Newborn Girl

Perineal groove is a rare congenital anorectal malformation, with incidence yet undetermined. It is almost exclusive to the female newborn and its embryogenic origin remains uncertain. We present a case-report of a newborn girl that was discharged from the nursery without complications. At her first appointment at primary care we noted a wet sulcus connecting the posterior vaginal commissure and the anus. This case report emphasizes the rarity of the perineal groove and the importance of a good quality history and physical examination at primary care.

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