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2020, Number 3

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Rev Hematol Mex 2020; 21 (3)

Polycythemia vera and severe neutropenia

Silva-Vera, M, Jiménez-González MJ, Moreno-Pérez NE, Moreno-Pizarro E, Máximo-Galicia P

Language: Spanish
References: 25
Page: 153-157
PDF size: 256.30 Kb.


ABSTRACT

Background: Neutropenia, defined as a sustained neutrophil count of less than 1.5 x 109/L, is a common hematologic abnormality that may be transient or chronic. The identification of the JAK2 V617F mutation is an important diagnostic criterion for classical myeloproliferative neoplasms, such as polycythemia vera, essential thrombocythemia and primary myelofibrosis. However, this mutation is also observed in other myeloid neoplasms, such as acute myeloid leukemia and myelodysplastic syndrome, although with a frequency considerably lesser than that of classical myeloproliferative neoplasms. Neutropenia is not a diagnostic criterion for other myeloid neoplasms and in the diagnostic algorithms for neutropenia the measurement of the JAK2V617F mutation is excluded.
Clinical case: A 69-year-old male patient who was referred to the outpatient hematology department for neutropenia of one year of evolution is reported, with a history of being treated by the emergency department for precordialgia and dyspnea, ruling out all cardiorespiratory diseases. Hematic biometrics evidenced only severe neutropenia. The peripheral blood smear did not report morphological abnormalities. A subsequent blood count showed hemoglobin values of 17.5 g/dL, and hematocrit of 47.9%, so, it was decided to identify the JAK2 mutation resulting positive.
Conclusions: Currently the patient is treated with hydroxycarbamide. The communication of this case allows demonstrating the importance of the good clinical study of the patient and the adequate correlation of laboratory studies to establish a timely and accurate diagnosis.


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