Unusual involvement of the portal vein in polycythemia vera-genetic perspective

Polycythaemia Vera or erythrocytosisis a medical condition with high concentration of red blood cells. The thicker blood is less able to travel through blood vessels and organs. Most symptoms of polycythaemia are related tothis sluggish blood flow. Moderate symptoms of polycythaemia include headache, blurredvision, red skin, tiredness, elevated blood pressure, dizziness, abdominal discomfort, bleeding problems, gout and itchy skin although more severe medical events like vas-occlusion, thrombosis and strokes may occur. This case reports a 50 year old female with an unusual presentation of polycythemia vera in the form of abrupt onset &one-day-old' history of massive hematemesis with otherwise unremarkable physical exam except caput medusa around umblicus. A diagnosis of Polythythaemiavera complicated by portal vein thrombosis induced portal hypertension was finally made.Patients with polycythemia vera are at high risk of vaso-occlusive events. While the etiology of events in polycythemic patients is likely to be multifactorial, hemodilution is potentially beneficial. Attending clinicians should be well aware of the unlikely associations and squeal of thrombotic events in polycythemia vera like portal venous occlusion and hypertension.