RESUMEN
Polycythemia vera (PV) and heterozygous beta-thalassemia (HBT) have opposing effects on the hematocrit (Hct) and may mask the presence of each other. Missing the diagnosis of PV may have serious consequences, mainly by exposing the patient to the risk of thromboses. We present a case where the diagnosis of PV was delayed due to the coexistence of HBT, and review the relevant literature. It can be postulated that "stress erythropoiesis", known to occur in patients with thalassemic syndromes, increases the probability of somatic JAK2 mutations leading to development of PV.
RESUMEN
BACKGROUND: It is not unusual for systemic diseases to mimic sepsis and, in any case, the clinician should thoroughly investigate this possibility. CASE PRESENTATION: We present the case of a 21-year-old Greek woman who presented to the Intensive Care Unit of our hospital with severe septic shock - multiple organ failure as a result of a suspected gynecological infection of the ovaries. An immediate improvement of her clinical condition in combination with strong clinical suspicion and negative cultures led to the differential diagnosis of diseases other than sepsis. Based on the results of the biopsies that were obtained by research laparotomy, our patient suffered from primary Burkitt ovarian lymphoma. Her clinical condition improved with supportive treatment and chemotherapy. Chemotherapy is the dominant treatment for Burkitt's lymphoma, while surgery or radiotherapy has no place. CONCLUSIONS: All intensivists should be aware of clinical conditions that mimic sepsis as early diagnosis can lead to appropriate therapy and avoid unnecessary diagnostic tests and antibiotic abuse.
