The patient had been worked up for elevated Hgb by the hematology and oncology service and a JAK2 mutation was found.
The patient was noticed left-sided facial droop, slurred speech, and difficulty keeping liquids in his mouth.
A CBC, a complete metabolic panel, a head CT, a head CT angiogram, an EKG, and a blood troponin level were obtained.
An MRI of the head with gadolinium contrast was obtained, and the patient was started on 60 mg of prednisone for 7 days for treatment of his Bell’s palsy.
The patient was provided detailed instructions on the need for representation to the emergency department and provided education on his condition and its cause. He was set up to see outpatient neurology and his primary care doctor.
Declarations
Acknowledgments
The authors acknowledge the bedside nurses who constantly provide watchful eyes and care for our patients in order to ensure safe care around the clock. And this material is based upon work supported (or supported in part) by the Department of Veterans Affairs, Veterans Health Administration.
Authors contributions
AS, AA, and AB: Conceptualization, Writing—original draft. TCV: Conceptualization, Supervision, Writing—review & editing, Writing—original draft. All authors were involved in approving the final project for publication.
Conflicts of interest
The authors declare that they have no conflicts of interest.
Ethical approval
The ethical approval of this manuscript is exempted by the Institutional Review Board (IRB) of the Phoenix VA Health Care System Special Hospital.
Consent to participate
Informed consent to participate in this study was obtained from the patient.
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