Answer 27

 

This answer was emailed by Dr. Martin:

"... A 75 year-old male patient with recurrent ischemic attacks end by gangrene (thrombosis), splenomegaly, pruritus after hot bath.

The case is polycythemia.

Please check his blood picture, also secondary causes should be excluded: chest x ray (chronic pulmonary disease or COPD) and abdominal u/s or better CT to exclude malignancy (RCC or hepatoma), however the LONG STORY (3 years) may exclude malignancy.

Polycythemia vera is a provisional diagnosis..."

Thanks for your answer.

 

Another answer sent by Dr. Amira:

"A case of polycyathemia rubra vera causing thrombotic peripheral ischemia treated by venesection.."

Thank you for your answer.

 

Another one sent by Dr. Hatem:

"Digital ischemia associated with hot bath pruritis is highly suggestive of the diagnosis of polycythemia vera. Dx. can be confirmed by doing CBC LOOKING FOR THE HEMATOCRITE VALUE. Treatment: Phlepotomy "

Thank you, right answer.

 

 

 

 

Just C.B.C. was sufficient, yes it was a case of polycythemia it seems so simple so that it was far from thinking throughout those years.