International Case Reports Journal (ISSN: 2770-9647) | Volume 5, Issue 1 | Case Report | Open Access
PK Sasidharan*
Azmil K1 and Sasidharan PK2*
1Junior Resident, District Cooperative Hospital, Kozhikode, India
2Senior Consultant, District Cooperative Hospital, Kozhikode, India
*Correspondence to: PK Sasidharan
Fulltext PDFPolycythemia Vera (PV), a chronic myeloproliferative neoplasm, may evolve into myelofibrosis and may rarely transform into acute leukemia after a prolonged course of 10-15 years or even longer. Early blast crisis is uncommon, and its precipitation by an unusual infection with overlapping features of autoimmunity is extremely rare. In addition, it is unusual for PV to enter spent phase very early after diagnosis and having highest ever reported total leukocyte count of 2.57 lakhs/L (257 × 109/L) during spent phase, which on peripheral smear was reported erroneously as CML chronic phase. We had to do BCR- ABL and a repeat JAK 2 mutation analysis to differentiate between myelofibrosis and CML. We have noticed autoimmune disorders to coexist with myeloproliferative disorders but in this case, after a mycoplasma pneumonia infection, there was a heightened autoimmune manifestations and blast transformation of PV. There was DCT positive autoimmune hemolysis with very low platelet count and falling Hb and the peripheral blood did not show blasts, but the bone marrow only confirmed leukemic transformation.
Azmil K, Sasidharan PK. Polycythaemia Vera Spent phase with Highest TLC, Blast Crisis Following Mycoplasma Infection and Autoimmune Haemolysis: A Rare Case Report. Int Case Rep Jour. 2026;5(1):1-5.