Polycythemia

For patient information on Neonatal polycythemia, click here

Overview
Polycythemia is a condition in which there is a net increase in the total number of red blood cells in the body. The overproduction of red blood cells may be due to a primary process in the bone marrow (a so-called myeloproliferative syndrome), or it may be a reaction to chronically low oxygen levels or, rarely, a malignancy.

Primary polycythemia (Polycythemia vera)
Primary polycythemia, often called polycythemia vera (PCV), polycythemia rubra vera (PRV), or erythremia, occurs when excess red blood cells are produced as a result of an abnormality of the bone marrow. Often, excess white blood cells and platelets are also produced. Polycythemia vera is classified as a myeloproliferative disease.

Complete Differential Diagnosis for Polycythemia

 * Acute leukoses
 * Androgen Therapy
 * Cerebellar hemangioblastoma
 * Cushing's Syndrome
 * Decreased arterial PO2
 * Familial erythrocytosis
 * Hydronephrosis
 * Hyperthyroidism
 * Liver Tumors
 * Lung Tumors
 * Pheochromocytoma
 * Polycythemia Vera
 * Pregnancy
 * Primary hyperaldosteronism
 * Reduced plasma volume
 * Renal cysts
 * Renal Cell Carcinoma
 * Tissue hypoxia
 * Toxins
 * Uterine leimyoma

Symptoms
Some symptoms of this disease is experiencing: headaches, weakness, dizziness (vertigo), and/or a ringing noise in the ear (tinnitus). In some cases, individuals with polycythemia vera experience itching (pruritis), especially after a hot bath. Affected individuals often have an abnormally enlarged spleen (splenomegaly) and/or liver (hepatomegaly). In some cases, affected individuals may have associated conditions including high blood pressure (hypertension), the formation of blood clots (thrombosis), rupturing of and loss of blood (hemorrhaging) from certain blood vessels, and/or Budd-Chiari syndrome, a rare disorder characterized by obstruction (occlusion) of veins of the liver (hepatic veins).

Secondary polycythemia
Secondary polycythemia is caused by either natural or artificial increases in the production of erythropoietin that result in an increased production of erythrocytes. In secondary polycythemia, there may be 6 to 8 million and occasionally 9 million erythrocytes per cubic millimeter of blood. A type of secondary polycythemia in which the production of erythropoietin increases appropriately is called physiologic polycythemia. Physiologic polycythemia occurs in individuals living at high altitudes, where oxygen availability is less than at sea level. Many athletes train at higher altitudes to take advantage of this effect &mdash; a legal form of blood doping. Actual polycythemia sufferers have been known to use their condition as an athletic advantage for greater stamina.

Other causes of secondary polycythemia include smoking, renal or liver tumors, or heart or lung diseases that result in hypoxia. Endocrine abnormalities, prominently including pheochromocytoma and adrenal adenoma with Cushing's syndrome are also secondary causes. Athletes and bodybuilders who abuse anabolic steroids or erythropoietin may develop secondary polycythemia.

Relative polycythemia
Relative polycythemia is an apparent rise of the erythrocyte level in the blood; however, the underlying cause is reduced blood plasma. Relative polycythemia is often caused by fluid loss eg. burns, dehydration and stress polycythemia.

Polycythaemia vera Policitemia Eritrozitosi Maladie de Vaquez Policitemia פוליציטמיה Eritrocitozė 多血症 Czerwienica prawdziwa Полицитемия истинная