title: Development of polycythaemia vera in a patient with myelofibrosis.
abstract: In March 1981, a 53-year-old man presented with itching and was diagnosed as having myelofibrosis. There was gradual enlargement of the spleen over the following 5 yr. His spleen had to be removed in February 1986 because of physical discomfort. 3 months post-splenectomy he became polycythaemic. Bone marrow examination was consistent with severe myelofibrosis. It was possible to demonstrate erythropoietin-independent BFU-E from peripheral blood, and ferrokinetic studies showed that erythropoiesis was localised to the liver with little bone marrow activity. Thus, despite severe marrow fibrosis, liver erythropoiesis was now polycythaemic, suggesting the coexistence of myelofibrosis and polycythaemia vera.
authors.affiliation: Department of Haematology, Hammersmith Hospital, London, U.K.
authors.forename: I
authors.initials: I
authors.lastname: Dokal
authors.forename: A
authors.initials: A
authors.lastname: Pagliuca
authors.forename: M
authors.initials: M
authors.lastname: Deenmamode
authors.forename: G J
authors.initials: GJ
authors.lastname: Mufti
authors.forename: S M
authors.initials: SM
authors.lastname: Lewis
mesh_terms: D001853:Bone Marrow / Q000473:pathology; D004920:Erythropoiesis; D006801:Humans; D007504:Iron Radioisotopes; D008099:Liver / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011086:Polycythemia / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D055728:Primary Myelofibrosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D011877:Radionuclide Imaging; D013163:Splenomegaly / Q000209:etiology
chemical_list: D007504:Iron Radioisotopes