title: Transient ischaemic attack secondary to paraneoplastic erythrocytosis.
abstract: A 67-year-old woman with a history of hypertension and type 2 diabetes mellitus was admitted to the hospital due to aphasia and left-sided hemiparesis during the past 5 h with resolution of symptoms within 24 h. On admission laboratory analysis showed haemoglobin 19.2 g/dL and haematocrit 55.1%. Cerebral CT scan was also performed on admission revealing periventricular leucoaraiosis. Studies to investigate the cause of erythrocytosis were started and elevated erythropoietin levels were found. In order to investigate a secondary cause of erythrocytosis an abdominal ultrasound was conducted revealing a left renal mass. CT scans of thorax, abdomen and pelvis confirmed renal mass 8 × 8 cm of diameter, suggestive of neoplasm without associated lymphadenopathy or metastases. Radical nephrectomy was performed and a pathological diagnosis demonstrated clear cell renal cell carcinoma and was staged as T2aN0M0.
authors.affiliation: Department of Internal Medicine, San Juan de Dios General Hospital, Guatemala, Guatemala.
authors.forename: Aldo René
authors.initials: AR
authors.lastname: Hurtarte Sandoval
authors.affiliation: Department of Rheumatology, Puerta de Hierro Majada Honda Hospital, Madrid, Spain.
authors.forename: Bryan Josué
authors.initials: BJ
authors.lastname: Flores Robles
authors.affiliation: Independence Village, Independence Polyclinic, Cayo, Santa Elena Town, Belize.
authors.forename: Robert Francis
authors.initials: RF
authors.lastname: Andrus
authors.affiliation: Department of Neurology, San Juan de Dios General Hospital, Guatemala, Guatemala.
authors.forename: David Alejandro
authors.initials: DA
authors.lastname: Yaxcal Chon
mesh_terms: D000368:Aged; D002292:Carcinoma, Renal Cell / Q000150:complications* / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000209:etiology*; D007680:Kidney Neoplasms / Q000150:complications* / Q000601:surgery; D009392:Nephrectomy; D010257:Paraneoplastic Syndromes / Q000150:complications*; D011086:Polycythemia / Q000150:complications*; D016896:Treatment Outcome