Abstract
Here described 73-year-old woman who had showed remarkable hemorrhagic diathesis for a few months. The color of her skin was dark reddish and mucous membrane ruddy and cyanotic. Subcutaneous hemorrhage was observed on the anterior chest and forearms. Peripheral blood examination revealed pancythemia, particularly erythrocytosis.
Hematological findings disclosed red-blood cells 8,070,000, hemoglobin 16.8 gm/100 ml., hematocrit 54.9%, white-blood cells 16,100 and thrombocytes 322,000.
She was diagnosed polycythemia vera from physical signs and laboratory findings. Coagulation study was performed because her remarkable hemorrhagic diathesis in spite of thrombocythemia. Except the positive tourdiquet test and low plasma fibrinogen we could not detect a deficiency of coagulation factors nor accelerated fibrinolysis. The hemorrhagic mechanism in this case may chiefly concern with the hemodynamics and the fragility of perivascular tissues. Lysozyme (Muramidase) activity in her serum and urine was elevated compared with control group. These findings may suggest that not only erythropoiesis but granulopoiesis may elevated in polycythemia vera.
