Acute Onset Symptomatic Polycythaemia Vera

Polycythaemia vera(PV) is a myeloproliferative neoplasm (MPN) that is chronic and insidious in its evolution. The diagnosis of MPNs is based on criteria set out by the Polycythaemia Vera Study Group (PVSG) and the WHO [1,2,3,4,5]. These diagnostic criteria are directed primarily at the exclusion of other myeloproliferative neoplasms (MPN) and of other clinical conditions that could account for the cytopenias. It is well documented that iron deficiency could mask the presentation of PV, but I here present a case of PV that was masked by a low grade lymphoma and presented acutely within 24 hours of a splenectomy in a dramatic fashion.