Digital Gangrene Accelerated by Diabetic Ketoacidosis in the Setting of Polycythemia Vera

Author(s): Goonja Patel, Sachi Singhal, Pushti Khandwala, Oladimeji Lanade, Robert Kleyman

Polycythemia vera is a disease process resulting in excess production of blood cells and platelets in the bone marrow which actuates ischemic events in both the large and small vessels in the body. This underlying risk of thromboembolism is further compounded by other ischemic burdens, such as diabetic ketoacidosis. We present an unusual case of a female with polycythemia vera who was diagnosed with ischemic gangrene in her extremities as a result of diabetic ketoacidosis, despite having only mildly elevated blood counts from her underlying disease. We will review the various treatment options currently available for polycythemia vera.