von Hippel-Lindau Disease and Erythrocytosis

von Hippel-Lindau Disease and Erythrocytosis Case ReportA 37-year-old man, who complained about a headache, nausea, and vomiting, was referred to our hospital.From childhood, the patient presented with erythrocytosis secondary to a high erythropoietin level.This persisting increased level was not associated with cardiopulmonary and renal diseases, tumors, or hemoglobinopaties.Since the age of 7 years, the patient was treated with periodic phlebotomies and a low-dose of aspirin.Furthermore, at the age of 30 years, the patient underwent surgery for welldifferentiated pheochromocytoma.The patient received his last phlebotomy 2 weeks before our visit.At that time, all investigations for pheochromocytoma (including an abdominal computed tomography scan and the level of catecholamines) were normal, and hematologic parameters were as follows: hemoglobin, 11.8 g/dL; hematocrit, 46%; mean cell volume, 61.5 fL; RBC, 7.62 10 12 /L; WBC, 8.76 10 9 /L; and platelets, 497 10 9 /L.Because he had stopped taking aspirin for a few months in the past, we suspected that the headache, nausea, and vomiting could be ascribed to a possible cerebral thrombosis.Actually, the magnetic resonance imaging angiography of the brain demonstrated the presence of bilat-