A 59-year-old man presents with headaches, dizziness, and intense pruritus after hot showers. Vital signs show BP 158/92 mmHg, HR 88/min, RR 16/min, temp 37.2°C. Examination reveals facial plethora and splenomegaly. Laboratory studies show hemoglobin 18.5 g/dL, hematocrit 58%, platelets 450,000/μL, and serum erythropoietin 2 mIU/mL (low). Leukocyte alkaline phosphatase is elevated. No fever or weight loss reported. Which of the following is the most likely diagnosis?
- A)Essential thrombocythemia
- B)Polycythemia veraGABARITO
- C)Chronic myelogenous leukemia
- D)Waldenstrom macroglobulinemia
- E)Secondary polycythemia due to hypoxia
Explicação
Polycythemia vera is correct. This JAK2 driven myeloproliferative neoplasm causes autonomous red cell production, often with leukocytosis or thrombocytosis as well. Pruritus after hot showers, low erythropoietin, plethora, and splenomegaly are classic clues. Ver explicação completa e trilha adaptativa →