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A 48-year-old man was referred to the outpatient clinic because of fatigue and an elevated haemoglobin level of 19.4 g/dL. His relevant medical history only revealed psychosis. He had quit cigarette smoking for several years. His daily medication schedule consisted of valproic acid 1500 mg, quetiapine 400 mg and lormetazepam 1 mg daily. There were no clinical abnormalities besides a body mass index of 28.3 kg/m².
Since primary erythrocytosis was not excluded initially, venesections were performed three times. Meanwhile, diagnostic work-up took place. Serum erythropoietin levels and V617F JAK-2 mutation were normal. Red blood cell mass nuclear scintigraphy showed an absolute elevation in red …
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