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-
1
Nishimura M, Mashimo M, Suzuki Y et al.: Digital arterial occlusions without acral ischemic change as the first manifestation of polycythemia vera. Arch Dermatol 125: 1439, 1989.
-
2
Barabas AP: Surgical problems associated with polycythemia. Br J Hosp Med 23: 289, 1980.
-
3
Haider MZ, Anwer F: Secondary Polycythemia, Treasure Island, FL, StatPearls Publishing, 2021.
-
4
Barbui T, Thiele J, Vannucchi AM et al.: Rationale for revision and proposed changes of the WHO diagnostic criteria for polycythemia vera, essential thrombocythemia and primary myelofibrosis. Blood Cancer J 5: e337, 2015.
-
5
Campbell PJ, Green AR: Management of polycythemia vera and essential thrombocythemia. Hematology Am Soc Hematol Educ Program 2005: 201, 2005.
-
6
Teffei A, Barbui T: Polycythemia vera and essential thrombocythemia: 2017 update on diagnosis, risk-stratification, and management. Am J Hematol 92: 94, 2017.
-
7
Getaz P, Jacobs P, and Louw JH: Peripheral gangrene in polycythaemia vera. Postgrad Med J 51: 733, 1975.
-
8
Annetts DL, Tracy GD: Idiopathic thrombocythaemia presenting with ischaemia of the toes: report of three cases. Med J Aust 2: 180, 1966.
-
9
Walden R, Adar R, Mozes M: Gangrene of toes with normal peripheral pulses. Ann Surg 185: 269, 1977.
-
10
Wollina U, Koch A, Heinig B et al.: Cutaneous microembolism of fingers and toes. Open Access Maced J Med Sci 6: 166, 2018.
-
11
Graham-Brown RAC, Holmes R: Polycythemia rubra vera with lamellar dystrophy of the nails: a report of two cases. Clin Exp Dermatol 5: 209, 1980.
-
12
Ahmed A, Shah KA: Peri-operative management of a patient with uncontrolled polycythemia vera for above knee amputation. J Pak Med Assoc 54: 34, 2004.
-
13
Michiels JJ: Erythromelalgia and vascular complications in polycythemia vera. Semin Thromb Hemost 23: 441, 1997.
Polycythemia as an Underlying Cause of Digital Gangrene: A Rare and Unusual Case Presentation
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Digital gangrene is frequently encountered in patients who have diabetes with peripheral vascular compromise, with or without superimposed infection. Preoperative laboratory values and radiographic images are important to determine a proper course of action. Equally important is a thorough history taking to confirm or rule out systemic entities and preexisting conditions that can aggravate or predispose one to the development of digital gangrene. A patient with diabetes presented with a rare and unusual case of digital gangrene, as he clinically had strong pedal pulses. Preoperative workup revealed a suspicion of polycythemia, which was subsequently confirmed. The patient underwent several days of phlebotomy until his hemoglobin and hematocrit levels were brought down to optimized levels before a digital amputation was performed. He went on to heal uneventfully, and he is currently being closely followed by oncology/hematology colleagues with periodic phlebotomy.
