ISSN: 2329-8790
Michiels JJ
The main primary symptoms in 363 MPN patients subdivided in 123 ET, 190 PV and 50 MF patients were fatigue, night sweats, pruritis and bone pain. MPN diagnosis was based on symptoms in 56% (n = 203), detected by coincidence in 30% (n = 110) and based on complications in 14% (n = 49). The 497 MPN patients were on treatment with low dose aspirin in 70%, phlebotomy in 42% (mainly PV 91%), hydroxyurea in about 30% of ET, PV and MF, and pegylated interferon-alpha2a in 16% of ET and PV patients at time of evaluation. The MPN patients were limited in physical mobility in 10%, 14% and 24%, limited in the ability to exercise in 15%, 29% and 38% and social activity was restricted in 9%, 11% and 11% of ET, PV and MF patients respectively. Non-retired MPN patients experienced self-reported fatigue as the main reason for the inability to work full-time in 31% of ET, 40% of PV and 59% of MF patients. The top 20 complaints at time of diagnosis in 399 out of 497 (81%) MPN patients was fatigue (81%) equally high in ET, PV and MF patients. Apart from fatigue about 40% to 60% of ET and PV patients presented with aspirin responsive microvascular disturbances. Itching (PV 58% vs ET 30%) and fatigue were much more prominent in PV. About one third of MPN (ET, PV and MF) patients suffered from bone pain. MF patients suffered more frequently from constitutional symptoms of prominent fatigue and night sweats related to pronounced splenomegaly. Before the diagnosis was made in 497 MPN patients, the complaints were ascribed to other causes in 173 (35%): to stress, burned out or overstrained in 41 (24%), to depression or hystery in 14 (8%), migraine of unknown origin in 13 (8%) and to rheuma, hypertension or fibromalgia in a few.