Cases reported "Polycythemia Vera"

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1/46. Anemic infarction of the liver resulting from hepatic and portal vein thrombosis.

    True anemic infarction of the liver is a rare lesion. Most of the reported cases are due to occlusion of the hepatic artery. Whether venous occlusion can result in such anemic infarcts has been disputed although few authentic cases have been reported. A case of polycytheia vera complicated by hepatic and portal vein thrombosis with anemic infarction of a large segment of the liver is presented. The case illustrates that anemic infarcts of the liver can result from venous occlusion. The intense congestion secondary to hepatic vein occlusion may cause secondary arterial hypoperfusion unless the portal vein is available as an outflow tract.
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ranking = 1
keywords = thrombosis, vein thrombosis, vein
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2/46. Long-term successful coronary artery angioplasty in polycythemia vera.

    In a 65-year-old man with polycythemia vera, invalidating angina pectoris was associated with severe narrowing of the right coronary artery. After percutaneous coronary angioplasty (PTCA) the patient became symptom free and remained so for 12 months, while receiving an antiplatelet agent, a calcium antagonist and nitrate. coronary angiography repeated after a year, because of reappearance of angina, documented good patency of the treated artery and some progression of a narrowing involving another coronary vessel. This is the first reported case of long-term success of PTCA in polycythemia vera, a disease exposed to a high risk of thrombosis and, possibly, of restenosis. It is undefined whether medical treatment contributed to the anatomical and clinical results. As far as a single case can say, polycythemia vera might not represent a prohibitive background for coronary PTCA.
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ranking = 0.19434914873946
keywords = thrombosis
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3/46. budd-chiari syndrome complicating restorative proctocolectomy for ulcerative colitis: report of a case.

    PURPOSE: This is a case of hepatic vein thrombosis presenting in a delayed fashion after proctocolectomy with ileal pouch-anal anastomosis for ulcerative colitis. Search for a causative thrombotic condition resulted in the diagnosis of polycythemia vera, a myeloproliferative disorder associated with hypercoagulability. The polycythemia was masked by an iron deficiency associated with the ulcerative colitis. methods: The history, physical, diagnostic modalities, and treatment for this patient are described, and the literature of budd-chiari syndrome associated with ulcerative colitis is reviewed. RESULTS: Six cases of budd-chiari syndrome in the setting of ulcerative colitis are reported in the literature from 1945 to 1997. CONCLUSIONS: Hepatic vein thrombosis is a rare complication of ulcerative colitis. The diagnosis of budd-chiari syndrome demands a thorough search for a hematologic condition predisposing to thrombosis. Our patient had a myeloproliferative disorder, polycythemia vera, that is associated with a hypercoagulable state. The disorder was masked by an iron deficiency associated with the ulcerative colitis. Recognition of the entity will permit successful treatment.
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ranking = 0.59405179246707
keywords = thrombosis, vein thrombosis, vein
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4/46. Thrombotic pulmonary arteriopathy in polycythemia vera.

    pulmonary infarction and hemorrhage are important differential diagnoses in pulmonary coin lesions, especially in patients with underlying hematologic malignancies. We report a 58-year-old female patient suffering from polycythemia vera presenting with multiple pulmonary coin lesions. Open lung biopsy and subsequent histologic investigations showed organized pulmonary infarction and primary pulmonary thrombotic arteriopathy. Although histologic features are non-contributory in distinguishing organized thrombosis from organized thromboembolism, the clinical setting and localization of the lesions suggest that in the present case the vascular lesions are due to organized thrombosis.
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ranking = 0.38869829747891
keywords = thrombosis
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5/46. Successful anticoagulation with hirudin in a patient with mesenteric venous thrombosis and multiple coagulation abnormalities.

    A case of multiple thrombotic diatheses discovered in the setting of mesenteric venous infarction is discussed. The patient had deficiencies of protein c, protein s, antithrombin iii; was heterozygous for factor v Leiden; and had polycythemia vera. Adequate anticoagulation could not be established with heparin administration and hirudin was used. The diagnosis of mesenteric venous infarction, thrombotic tendency of multiple coagulation diatheses, and use of hirudin are discussed.
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ranking = 0.80306686770508
keywords = thrombosis, venous thrombosis
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6/46. Recurrent coronary stent thrombosis.

    A 63-year-old woman with an acute anterior myocardial infarction was treated with primary stent implantation. The absence of coronary artery stenosis and an haematocrit of 58 were indicative of a myeloproliferative disorder and the diagnosis of polycythaemia vera (Vaquez' disease) was confirmed by bone marrow aspiration. The patient had a re-infarction 8 days later. A rescue percutaneous angioplasty was performed for stent thrombosis after unsuccessful thrombolysis. A few hours after sheath removal, a femoral artery thrombosis at the puncture side needed urgent thrombectomy. Finally, a second re-infarction occurred, followed by an irreversible cardiac arrest. Stent thrombosis is a difficult-to-treat complication in patients with polycythaemia vera. If this haematologic disorder is known, primary stent implantation for acute myocardial infarction may not be the first choice in these patients.
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ranking = 1.3604440411762
keywords = thrombosis
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7/46. diffusion-weighted magnetic resonance imaging in two patients with polycythemia rubra vera and early ischemic stroke.

    Polycythemia rubra vera (PRV) is a rare myeloproliferative disorder with a high risk of ischemic stroke. Although thrombosis of large cerebral arteries is the most frequently presumed pathomechanism, various infarct patterns have been described in patients with PRV and ischemic stroke. We report two patients with mild acute ischemic strokes and known PRV, in whom a scattered lesion pattern was detected by diffusion-weighted magnetic resonance imaging (DWI), but was not visible on computed tomography (CT) and conventional magnetic resonance imaging (MRI). Further diagnostic work-up including extra- and transcranial Doppler sonography (ECD, TCD), transesophageal echocardiography (TEE), magnetic resonance angiography and Holter monitoring revealed no obvious sources of cerebral embolism in both cases. However, TEE in one patient demonstrated spontaneous echo contrast (SEC) in the left atrium. In both patients the symptomatology resolved completely. The detection of a scattered infarct pattern by DWI in patients with PRV and acute ischemic stroke has not been reported previously. DWI findings together with the SEC in one patient emphasize the assumption that a prothrombotic state with subsequent arterial embolism rather than local arterial thrombosis may be the underlying pathomechanism of stroke in some patients with PRV. Adding DWI to the diagnostic work-up may help to clarify etiology in patients with PRV and acute ischemic stroke.
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ranking = 0.38869829747891
keywords = thrombosis
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8/46. polycythemia vera--a case report and discussion on pathogenic mechanisms of increased thrombosis.

    polycythemia vera is a myeloproliferative disorder characterized by increased red cell mass and frequently complicated by venous and arterial thrombosis. The mechanism underlying the increased incidence of thrombotic events remains illusive. Presented in this report are a case of a 77-year-old man diagnosed with polycythemia vera and a review of the current literature on the mechanisms underlying the increased incidence of thrombotic events in polycythemia vera.
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ranking = 0.97174574369728
keywords = thrombosis
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9/46. Early medical treatment is life saving in acute Budd-Chiari due to polycythemia vera.

    Here we describe two women with polycythemia vera presented with fulminant hepatic failure due to acute budd-chiari syndrome. Both had a history of severe abdominal pain and distention of short duration. Clinical and laboratory findings showed fulminant hepatic failure due to acute budd-chiari syndrome. Diagnosis was confirmed with abdominal ultrasonography and Doppler ultrasonography showing ascites, hepatomegaly, portal hypertension and total occlusion of hepatic veins. Complete blood count and other clinical findings were compatible with polycythemia vera in both patients. patients were treated successfully with early administration of continuous heparin infusion, repeated phlebotomies and hydroxyurea. We emphasize here early diagnosis and effective treatment in such fulminant cases may be life saving.
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ranking = 0.00037169534048117
keywords = vein
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10/46. Qualitative platelet defect and thrombohaemorrhagic complications in a patient with polycythaemia vera. Case 10.

    We describe a 67-year-old patient with polycythaemia vera and pathological functional platelet studies. He not only suffered a transient ischaemic attack despite taking of antiplatelet agents, but also showed bleeding diathesis with cerebral bleeding and spontaneous suffusions. Platelet function studies and clinical findings improved after phlebotomy and cytoreductive treatment with hydroxyurea. Thrombosis and haemorrhage account predominantly for morbidity and mortality in patients with polycythaemia vera. The pathophysiological mechanisms to explain thrombosis and bleeding in patients with myeloproliferative disorders including polycythaemia vera were intensively studied. However, up to now no clear correlation of laboratory findings in relation to clinical history of thrombosis and bleeding was demonstrated. In this report the most important pathophysiological mechanisms and therapy with antiplatelet agents are discussed.
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ranking = 0.38869829747891
keywords = thrombosis
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