POLYCYTHEMIA that was clinically indistinguishable from polycythemia vera was observed in a patient who had splenectomy to palliate the anemia and hemolysis of hereditary spherocytosis. Polycythemia occurred 14 years after splenectomy, and the rubrocytes retained the spherocytic shape. There are several reports of polycythemia vera which occurred in patients with macrocytic anemia after treatment with vitamin B12, folic acid, or liver extract.1-7 We are aware of no example of hemolytic anemia in which sustained polycythemia occurred later. The following case is therefore of interest.
Report of Case
A 70-year-old white woman was followed in the clinic for 32 years. In 1932, when she was 38 years of age, she was pregnant. Jaundice, anemia, and splenomegaly were found on the first examination, and the signs of hemolytic anemia were recognized. The pregnancy, delivery, and puerperium were normal. One year after delivery she had intermittent pain in the right upper quadrant