Background: The association between polycythemia vera and peripheral neuropathy has been described previously but only as a late complication and only with sensory axonal polyneuropathy.
We presume the cause of polyneuropathy was hypoxia due to higher blood viscosity and dysfunction of platelet aggregation.
Cases Report: We report the cases of 3 female patients with symptoms and signs of slowly progressive sensorimotor axonal polyneuropathy confirmed with clinical and neurographic examination as first complication of polycythemia vera, which progressed to a major complication. Axonal damage was irreversible despite venipuncture.
Conclusions: Polycythemia vera is rarely manifested with symptoms of sensomotor polyneuropathy as the first signs of the disease, and should therefore be recognized by physicians to prevent further axonal damage and major complications of disease by venipuncture or cytostatic therapy.

Keywords: hypoxia, polycythemia vera, sensomotor axonal peripheral neuropathy,, axonal peripheral neuropathy, venipuncture