Hipertensión arterial en paciente joven secundaria a policitemia vera

Polycythemia vera (PV) is a myeloproliferative disorder with many different kinds of clinical presentations, from a simple laboratory finding up to very severe thrombotic phenomena. Patients with primary PV are sometimes hypertensive, while some patients with essential hypertension may have relative polyglobulia which resolves after blood pressure control. We present the case of a 16 years old man who was diagnosed of PV while he was been investigated because of recently discovered high blood pressure (BP). 24 hour ambulatory BP monitoring showed a nondipper pattern more frecuently seen in secondary forms of hypertension. After the initiation of PV treatment with arythroapheresis, BP values and the results of hour ambulatory BP monitoring became normal. High blood pressure as the first clinical sign of PV is rarely seen. The etiology of hypertension in PV is a controversial issue; endothelial dysfunction and the elevation of hematocrit appear to play role.