Neuropsychiatric disturbance detecting polycythemia vera myelofibrosis: a case report and literature review

Abstract

Read online

BackgroundNeuropsychiatric disturbances and chorea are less recognized consequences of polycythemia vera (PV), and their role in post-PV myelofibrosis (MF) has not been reported. Clinical features that predict post-PV MF lack specificity.Case presentationWe describe an elderly patient with PV who developed acute-onset reversible neuropsychiatric disturbances accompanied by generalized chorea and was finally diagnosed with post-PV MF after a bone marrow examination. We also reviewed four cases of late PV associated with neuropsychiatric symptoms since 1966 and analyzed their clinical characteristics and therapeutic effects.ConclusionOur case indicates that Janus kinase 2 (JAK2)-related PV is a treatable cause of late-onset chorea and that chorea may herald the deterioration of hematological parameters. Our case provides a clinically specific representation of post-PV MF. Patients with a long course of PV are recommended to undergo bone marrow re-examinations when they present with neuropsychiatric symptoms to achieve an early diagnosis of post-PV MF.

Keywords

• post-polycythemia vera myelofibrosis (post-PV MF)
• neuropsychiatric symptoms (NPS)
• chorea
• microcirculation disorder
• Janus kinase 2 (JAK2)