Spinal cord infarction during physical exertion due to polycythemia vera and aortoiliac occlusive disease: A case report

Wei Pin Lin, Da-Shen Kuan, Cho I. Lin, Lin Chieh Hsu, Yu-Ching Lin

Research output: Contribution to journalArticle

Abstract

Rationale: Spinal cord infarction is rarely caused by hypercoagulable states. Polycythemia vera (PV) is a myeloproliferative neoplasm that can contribute to thrombotic events due to increased blood viscosity. We report a case of spinal cord infarction due to extensive aortic thrombosis caused by PV. Patient concerns: A 56-year-old man presented with acute paraplegia and urinary retention during heavy physical exertion. Diagnoses: Imaging studies revealed spinal cord infarction at the T9 to T12 levels and aortoiliac occlusive disease. PV was diagnosed during workup for elevated hemoglobin level Interventions: The patient received intravenous hydration and anticoagulation for spinal cord infarction. PV was managed with phlebotomy and hydroxyurea. Courses of inpatient and outpatient rehabilitation programs were also given. Outcomes: The patient became urinary catheter-free 5 months after disease onset, and was able to walk with walker. The American Spinal Injury Association Impairment scale also improved from C at diagnosis to D during last follow-up. Lessons: Etiologic workup is important for patients with spinal cord infarction to direct specific treatment strategies. Physical exertion may act as a trigger for infarction in patients at risk for thrombotic events, and monitoring of neurologic status during and after periods of exercise is warranted.

Original languageEnglish
Article numbere12181
JournalMedicine (United States)
Volume97
Issue number35
DOIs
Publication statusPublished - 2018 Aug 1

Fingerprint

Physical Exertion
Polycythemia Vera
Infarction
Spinal Cord
Urinary Catheters
Blood Viscosity
Phlebotomy
Urinary Retention
Hydroxyurea
Paraplegia
Nervous System
Inpatients
Hemoglobins
Thrombosis
Outpatients
Rehabilitation
Exercise
Neoplasms

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

@article{a46f8700ac0043f0982886c5be1e17d1,
title = "Spinal cord infarction during physical exertion due to polycythemia vera and aortoiliac occlusive disease: A case report",
abstract = "Rationale: Spinal cord infarction is rarely caused by hypercoagulable states. Polycythemia vera (PV) is a myeloproliferative neoplasm that can contribute to thrombotic events due to increased blood viscosity. We report a case of spinal cord infarction due to extensive aortic thrombosis caused by PV. Patient concerns: A 56-year-old man presented with acute paraplegia and urinary retention during heavy physical exertion. Diagnoses: Imaging studies revealed spinal cord infarction at the T9 to T12 levels and aortoiliac occlusive disease. PV was diagnosed during workup for elevated hemoglobin level Interventions: The patient received intravenous hydration and anticoagulation for spinal cord infarction. PV was managed with phlebotomy and hydroxyurea. Courses of inpatient and outpatient rehabilitation programs were also given. Outcomes: The patient became urinary catheter-free 5 months after disease onset, and was able to walk with walker. The American Spinal Injury Association Impairment scale also improved from C at diagnosis to D during last follow-up. Lessons: Etiologic workup is important for patients with spinal cord infarction to direct specific treatment strategies. Physical exertion may act as a trigger for infarction in patients at risk for thrombotic events, and monitoring of neurologic status during and after periods of exercise is warranted.",
author = "Lin, {Wei Pin} and Da-Shen Kuan and Lin, {Cho I.} and Hsu, {Lin Chieh} and Yu-Ching Lin",
year = "2018",
month = "8",
day = "1",
doi = "10.1097/MD.0000000000012181",
language = "English",
volume = "97",
journal = "Medicine (United States)",
issn = "0025-7974",
publisher = "Lippincott Williams and Wilkins",
number = "35",

}

Spinal cord infarction during physical exertion due to polycythemia vera and aortoiliac occlusive disease : A case report. / Lin, Wei Pin; Kuan, Da-Shen; Lin, Cho I.; Hsu, Lin Chieh; Lin, Yu-Ching.

In: Medicine (United States), Vol. 97, No. 35, e12181, 01.08.2018.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Spinal cord infarction during physical exertion due to polycythemia vera and aortoiliac occlusive disease

T2 - A case report

AU - Lin, Wei Pin

AU - Kuan, Da-Shen

AU - Lin, Cho I.

AU - Hsu, Lin Chieh

AU - Lin, Yu-Ching

PY - 2018/8/1

Y1 - 2018/8/1

N2 - Rationale: Spinal cord infarction is rarely caused by hypercoagulable states. Polycythemia vera (PV) is a myeloproliferative neoplasm that can contribute to thrombotic events due to increased blood viscosity. We report a case of spinal cord infarction due to extensive aortic thrombosis caused by PV. Patient concerns: A 56-year-old man presented with acute paraplegia and urinary retention during heavy physical exertion. Diagnoses: Imaging studies revealed spinal cord infarction at the T9 to T12 levels and aortoiliac occlusive disease. PV was diagnosed during workup for elevated hemoglobin level Interventions: The patient received intravenous hydration and anticoagulation for spinal cord infarction. PV was managed with phlebotomy and hydroxyurea. Courses of inpatient and outpatient rehabilitation programs were also given. Outcomes: The patient became urinary catheter-free 5 months after disease onset, and was able to walk with walker. The American Spinal Injury Association Impairment scale also improved from C at diagnosis to D during last follow-up. Lessons: Etiologic workup is important for patients with spinal cord infarction to direct specific treatment strategies. Physical exertion may act as a trigger for infarction in patients at risk for thrombotic events, and monitoring of neurologic status during and after periods of exercise is warranted.

AB - Rationale: Spinal cord infarction is rarely caused by hypercoagulable states. Polycythemia vera (PV) is a myeloproliferative neoplasm that can contribute to thrombotic events due to increased blood viscosity. We report a case of spinal cord infarction due to extensive aortic thrombosis caused by PV. Patient concerns: A 56-year-old man presented with acute paraplegia and urinary retention during heavy physical exertion. Diagnoses: Imaging studies revealed spinal cord infarction at the T9 to T12 levels and aortoiliac occlusive disease. PV was diagnosed during workup for elevated hemoglobin level Interventions: The patient received intravenous hydration and anticoagulation for spinal cord infarction. PV was managed with phlebotomy and hydroxyurea. Courses of inpatient and outpatient rehabilitation programs were also given. Outcomes: The patient became urinary catheter-free 5 months after disease onset, and was able to walk with walker. The American Spinal Injury Association Impairment scale also improved from C at diagnosis to D during last follow-up. Lessons: Etiologic workup is important for patients with spinal cord infarction to direct specific treatment strategies. Physical exertion may act as a trigger for infarction in patients at risk for thrombotic events, and monitoring of neurologic status during and after periods of exercise is warranted.

UR - http://www.scopus.com/inward/record.url?scp=85052817928&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85052817928&partnerID=8YFLogxK

U2 - 10.1097/MD.0000000000012181

DO - 10.1097/MD.0000000000012181

M3 - Article

C2 - 30170466

AN - SCOPUS:85052817928

VL - 97

JO - Medicine (United States)

JF - Medicine (United States)

SN - 0025-7974

IS - 35

M1 - e12181

ER -