Summary
A 65-year-old woman developed severe chorea as the presenting symptom of the hyperviscosity syndrome together with polycythemia vera and an ovarian cyst. Whole blood viscosity was 69.5 centipoise at a shear rate of 1.1 s−1 (normal 12.0–22.0 centipoise). After four phlebotomies the chorea subsided completely, and the blood viscosity became normal. Hemoglobin level was stable at normal range and then increased to 18.0 g/dl with recurrence of the faciobuccal dyskinesia that disappeared promptly following the phlebotomies. This case emphasizes that in elderly patients with neurological disorders, such as chorea, polycythemia should be strongly considered as one of the treatable causes.
References
Borg-Costanzi JM, Mohr PD, Lewis D (1981) Primary polycythemia presenting with chorea. Postgrad Med J 57: 228–231
Bruyn GW, Padberg G (1984) Chorea and polycythemia. Eur Neurol 23: 26–33
Fermaglich J, Streib E, Auth T (1973) Chorea associated with systemic lupus erythematosus: treatment with haloperidol. Arch Neurol 28: 276–277
Gamboa ET, Issacs G, Harter DH (1971) Chorea associated with oral contraceptive therapy. Arch Neurol 25: 112–114
Lewis BV, Parsons M (1966) Chorea gravidarum. Lancet I: 284–286
Mas JL, Gueguen B, Bouche P, Derouesne C, Varet B, Castaigne P (1985) Chorea and polycythaemia. J Neurol 232: 169–171
Mazziotta JC, Phelps ME, Pahl JJ, Huang SC, Baxter LR, Riege WH, Hoffman JM, Kuhl DE, Lanto AB, Wapenski JA, Makham CH (1987) Reduced cerebral glucose metabolism in asymptomatic subjects at risk for Huntington's disease. N Engl J Med 316: 357–362
Monteverde A, Sasot S de, Bernardou EM de (1983) Chorea policitemica. Rev Neurol Arg 9: 3–8
Morre HHE, van Woerkom TCAM, Endtz LJ (1982) A case of chorea resulting from polycythemia vera. Clin Neurol Neurosurg 84: 125–130
Riddoch D, Jefferson M, Bickerstaff ER (1971) Chorea and oral contraceptives. Br Med J 4: 217–218
Silverstein A, Gilberg H, Wasserman LR (1962) Neurologic complications of polycythemia. Ann Intern Med 57: 909–916
Thomas DJ, Marshall J, Rose Russell RW, Wetherley-Main G (1977) Cerebral blood-flow in polycythemia. Lancet II: 161–163
Voiculescu V, Ionescu DA, Lazar G, Alecu C, Predscu C, Popa C, Xenakis A, Marcu I, Ghitescu M (1979) Two cases of choreatic syndrome caused by polycythemia vera. Eur Neurol 18: 96–100
Walton JN (1977) Brain's diseases of the nervous system, 8th edn. Oxford University Press, New York, pp 614–615
Yiannikas C, McLeod JG, Walsh JC (1983) Peripheral neuropathy associated with polycythemia vera. Neurology 33: 139–143
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Cohen, A.M., Gelvan, A., Yarmolovsky, A. et al. Chorea in polycythemia vera: a rare presentation of hyperviscosity. Blut 58, 47–48 (1989). https://doi.org/10.1007/BF00320237
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00320237