[Polycythemia vera and D-dimer-negative thromboembolism].
METHODS
A 65-year-old patient with polycythemia vera (PV) was admitted with a painful edema of the right arm lasting for 24 h. The D-dimer assay was negative. By phlebography the patient was diagnosed with a fresh thrombosis of the right subclavian vein. 1 week later she developed a D-dimer-negative symptomatic pulmonary embolism.


CONCLUSIONS
If clinical signs of a thromboembolic event are present, the negative predictive value of the D-dimer assay is not sufficient to abandon further definitive diagnosis. Since thromboembolic events are frequent in PV patients, a prophylactic treatment with low-dose acetylsalicylic acid is recommended.
Bäsecke
Jörg
J
Abteilung Hämatologie und Onkologie, Universitätsklinikum, Göttingen. jbaesec@gwdg.de
Conradi
Imme
I
Bramlage
Carsten P
CP
Scheel
Alexander K
AK
Trümper
Lorenz
L
D000368:Aged; D001132:Arm / Q000098:blood supply; D003937:Diagnosis, Differential; D004452:Echocardiography; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006801:Humans; D010690:Phlebography; D011087:Polycythemia Vera / Q000097:blood* / Q000150:complications / Q000175:diagnosis; D011655:Pulmonary Embolism / Q000097:blood* / Q000175:diagnosis; D013350:Subclavian Vein; D013927:Thrombosis / Q000097:blood* / Q000175:diagnosis; D014262:Tricuspid Valve Insufficiency / Q000097:blood / Q000150:complications / Q000175:diagnosis; D018615:Ultrasonography, Doppler, Color
D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D