title: Mesenteric infarction due to iatrogenic polycythemia.
abstract: BACKGROUND
  Polycythemia vera is defined as a chronic myeloproliferative disorder characterized by increased red blood cell count. There have been no reports on mesenteric thrombosis resulting from iatrogenic polycythemia.
  
  
  METHODS
  We present a patient with a history of non-small cell lung cancer undergoing maintenance oral chemotherapy on tarceva and adjunctive use of procrit. The patient presented to our emergency department with an acute abdomen and was found to have ischemic bowel from unmonitored procrit, which lead to hyperviscosity of blood and mesenteric infarction.
  
  
  RESULTS
  The patient remained intubated with ventilator support. He refused a tracheostomy. He continued on feeding through the J port of the nasojejunal tube. His white cell count, and hematocrit and creatinine levels remained normal. Procrit use and chemotherapy were not restarted. He was transferred to a subacute nursing facility for further treatment.
  
  
  CONCLUSIONS
  Procrit and other erythropoiesis stimulating drugs can cause significant morbidity and mortality with an increased risk of cardiovascular events, gastrointestinal bleeding, thromboembolism and stroke. This case report suggests that without closely monitoring hematocrit levels, epoetin may also be associated with an increased risk of mesenteric infarction.
authors.affiliation: University of Florida School of Medicine, Gainesville, FL, USA.
authors.forename: Katrina
authors.initials: K
authors.lastname: Skoog
authors.affiliation: University of Florida School of Medicine, Gainesville, FL, USA.
authors.forename: Marie
authors.initials: M
authors.lastname: Carmelle-Elie
authors.affiliation: University of Florida School of Medicine, Gainesville, FL, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Ferguson
keywords: Iatrogenic polycythemia; Mesenteric infarction