Keywords
polymorbidity
neutrophilosis
blast cells
myelocytes
aortic stenosis
JAK-2 and CALR gene mutations
How to Cite
Abstract
In the article analyzes clinical and diagnostic issues and management tactics of
a patient with essential thrombocythemia on the background of rheumatoid arthritis and
severe concomitant somatic pathology. We describe the case of a 67-year-old man who presented with complaints of pain and stiffness in the joints, general weakness, shortness
of breath, and swelling of the lower extremities. During the examination, it was found that
the patient had pronounced thrombocytosis, increased inflammation indicators with the
presence of rheumatoid factor, and over time, the patient's condition became complicated
by the appearance of gastrointestinal bleeding while taking NSAIDs.
During the examination of the patient, the following diagnoses were established: essential
thrombocythemia, duodenal ulcer, rheumatoid arthritis, aortic stenosis with chronic
cardiovascular failure of NYHA class III. Thanks to the treatment, it was possible to achieve
complete remission of peptic ulcer disease, improvement of the course of rheumatoid
arthritis and essential thrombocythemia, however, the clinical manifestations of chronic
cardiovascular failure remain. The patient is scheduled for surgical treatment of aortic
stenosis after blood parameters stabilize.
This clinical case is illustrative due to the presence of several different, pathogenetically
unrelated diseases in one patient and emphasizes the need for a comprehensive approach
and careful assessment of all symptoms.
References
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