Case Presentation: -
A 65-year Arabic female was diagnosed with PV in 2010 and followed in
our outpatient clinic. She is also known to have dyslipidemia, Atrial
fibrillation, and hypertension. She did not have a history of
thromboembolic events. So, according to her age (>60 years)
and presence of multiple comorbidities, she was categorized as having
high-risk PV. She was started on peginterferon alpha 135 mcg every 12
weeks and phlebotomy as needed to keep her hematocrit below 42%. Her
hematological indices were controlled.
In 2019, she presented to the primary health center complaining of
generalized body itching. She was started on antihistamine and steroids
ointments for a long time, but unfortunately, her itching did not
improve.
In 2022, she started on a low dose of ruxolitinib (5 mg daily) based on
the emerging evidence regarding its efficacy in PV cases with refractory
symptoms. As a result, she started to improve regarding her itching but
did not resolve it completely. So, after three months, the dose of
ruxolitinib was increased to 10 mg, and she started to experience
dramatically improved with complete resolution of itching.
She was followed for a few months and did not report any side effects
with good tolerance of ruxolitinib.