Abstract
This report describes the case of a 62-year-old woman with type 2 diabetes and painful diabetic peripheral neuropathy, who, despite standard treatment, experienced persistent symptoms. Further investigation revealed erythromelalgia secondary to polycythemia vera, confirmed by bone marrow biopsy and JAK2 V617F mutation. The patient received a multidisciplinary regimen, including pregabalin, aspirin, and interferon-alpha, resulting in significant symptom relief and improved hematologic parameters. Follow-up over 2 years confirmed sustained symptom resolution, highlighting the importance of considering concurrent or secondary pain factors when diagnosing and treating refractory neuropathic pain to avoid misdiagnosis or missed diagnosis.