Noninfectious Ascites Neutrophilia in a Patient With Polycythemia Vera

Author:

Mazumder Ritika1,Chatterjee Arjun1ORCID,Carey William2,Sengupta Shreya2

Affiliation:

1. Department of Internal Medicine, Cleveland Clinic, Cleveland, OH

2. Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH

Abstract

ABSTRACT A 59-year-old woman with polycythemia vera-related portal hypertension requiring frequent paracentesis was admitted for asymptomatic recurrent spontaneous bacterial peritonitis, which was diagnosed based on elevated polymorphonuclear (PMN) count. She had multiple similar admissions during which she was treated with antibiotics. The patient had chronic baseline leukocytosis due to polycythemia vera. Repeat paracentesis after intravenous antibiotics demonstrated persistent elevation of PMN count without clinical symptoms. A multidisciplinary team concluded that the increased PMN count was secondary to polycythemia. The patient was diagnosed with omental extramedullary hematopoiesis, a rare condition causing elevated PMN count in the absence of bacterial contamination.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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