34

We report the case of an 85-year-old woman admitted for necrosis of the third finger of the left hand. Clinical and imaging investigations revealed a segmental superficial venous thrombosis and digital arterial occlusions. Blood tests showed polycythemia associated with marked thrombocytosis (1,119,000/mm³). The presence of the JAK2 V617F mutation confirmed the diagnosis of polycythemia vera with associated thrombocytosis, according to the WHO criteria. The patient was treated with anticoagulation, antiplatelet therapy, phlebotomy, and cytoreductive treatment with hydroxycarbamide, combined with amputation of the necrotic finger. The outcome was favorable with progressive normalization of hematological parameters. This case highlights the importance of investigating for an underlying myeloproliferative neoplasm in cases of unexplained digital ischemia.