Polycythemia

Question 1

What is polycythaemia?

Answer 1

High concentration of RBCs in blood

Question 2

What causes primary polycythaemia (polycythaemia vera)?

Answer 2

JAK2V617 mutation (95% cases)

Question 3

What causes secondary polycythaemia (causes outside of bone marrow)?

Answer 3

Hypoxia
increased EPO
Dehydration
Alcohol

Question 4

What are symptoms of polycythemia?

Answer 4

Itchy after a bath
Burning fingers and toes (erythromelalgia)
Reddish plethoric complexion (purple face)
Blurred vision
Headache
Hepatosplenomegaly

Question 5

What is haematocrit?

Answer 5

Blood test measuring the proportion of RBCs in the total volume of blood, expressed as a percentage.

Question 6

Increased RBCs, means increased haematocrit which means (character of blood)…

Answer 6

more solid mass of blood

Question 7

What investigations would you do for suspected polycythemia?

Answer 7

FBC:
increased WBC, platelets and many more RBCs

Increased HB

Genetic testing: JAK2V167 positive

Question 8

What is the treatment for polycythemia?

Answer 8

Non-curative
maintain normal blood count
Venesection (removes about half a litre of blood)
Can give aspirin

In high risk patients consider hydroxycarbamide (chemotherapy)