Hypocoagulability and hyperfibrinolysis in polycythemia vera: a case report

Polycythemia vera (PV) is classified as a myeloproliferative neoplasm (MPN), a group of hematologic disorders. In PV, thrombosis is a leading cause of morbidity and mortality; however, hemorrhage is also a potentially life-threatening complication. The mechanisms of bleeding in PV are complex and multifactorial, including disturbances in platelet aggregation, vascular endothelial function and von Willebrand factor activity. Despite this, there are limited reports on the incidence of hyperfibrinolysis in PV and its role in bleeding events. We present a case of a PV patient with severe bleeding which was linked to both hypocoagulability and hyperfibrinolysis. We propose that PV patients with hemorrhage should be evaluated for all potential coagulation disorders, including hyperfibrinolysis, to ensure optimal patient care.