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March 1982

Polycythemia Vera

Arch Intern Med. 1982;142(3):642. doi:10.1001/archinte.1982.00340160222038

To the Editor.  —Godeau et al, in the June Archives (1981;141:951-953), reported the first case of polycythemia vera associated with primary hyperparathyroidism. We observed a similar case.

Report of a Case.  —A 73-year-old woman complained of pruritus and loss of weight. On hospital admission, physical examination findings were normal. The hematocrit value was 68%; WBC count, 12,700/cu mm; and platelet count, 470,000/cu mm. The RBC mass (chromated Cr 51 serum albumin) was 52 mL/kg. The leukocyte alkaline phosphatase score was 120. Arterial oxygen saturation was 95%. A technetium Tc 99m sulfur colloid liver-spleen scan showed mild splenomegaly. The serum calcium level was 11.3 mg/dL; phosphorus level, 3.6 mg/dL; chloride level, 111 mEq/L; and total CO2 level, 25 mEq/L. Renal function was normal. The blood parathyroid hormone level (carboxyl-terminal fragment) was repeatedly elevated (660, 663, 720, and 780 pg/mL; normal, 300 to 600 pg/mL). A bone roentgenogram and a technetium

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