Polycythemia
(Polycythemia Vera · Primary Polycythemia · Secondary Polycythemia)
In this condition factsheet:
Diagnosing Polycythemia
To diagnose polycythemia, a doctor will begin by discussing the patient's health history and doing a physical examination. The doctor will also look for physical signs of increased blood volume, such as dilated veins and a ruddy complexion. If the skin is flushed or itchy, particularly after a hot bath, it may indicate a diagnosis of polycythemia.
The doctor may also check for a history of smoking or alcohol abuse. A careful physical examination might also be done to check for high blood pressure, obesity, lack of oxygen (cyanosis), heart murmurs, or an enlarged spleen. Various blood tests will likely be done, including a complete blood cell count, erythropoietin level, and an assay to detect a JAK2 mutation. Additional tests will then be done to find out whether it is polycythemia vera or secondary polycythemia. These tests will probably include a history and physical examination, measurements of oxygen saturation. For some people, the doctor may suggest a bone marrow test.
Treating and Preventing Polycythemia
Treatment will vary according to the person's age, symptoms, and blood test results.
To reduce the risk of blood clots, treatment with low-dose acetylsalicylic acid* (ASA) is recommended for most people with polycythemia (unless there is a reason they should not take it).
Phlebotomy (removal of small amounts of blood) used to be the most common type of therapy for polycythemia vera.
When phlebotomy is used, blood will be withdrawn in amounts of 300 mL to 500 mL every few days at first, then every few weeks, and then every few months. The treatment goal will be to keep the blood hemoglobin level within the low-to-normal range. Often, the process of blood withdrawal can be stopped for months at a time if the hemoglobin level stays in the required range. For seniors or for people with heart or brain blood vessel disease, less blood is usually taken (i.e., only 200 mL to 300 mL twice a week). Once a person's hemoglobin levels are normal, they will probably have monthly doctor's appointments.
If the blood has high white blood cell and platelet counts in addition to a high content of red blood cells, the physician may prescribe a medication that cuts down blood cell production by the bone marrow (e.g., hydroxyurea, ruxolitinib).
Complications such as high uric acid blood levels and itchy skin may be treated with allopurinol or antihistamines, respectively.
In rare cases, the spleen can become extremely enlarged. The physician may recommend its surgical removal (splenectomy).
Anyone who has had a splenectomy must get vaccinations to prevent future infections.
Unfortunately, there's no way to prevent polycythemia vera. However, you may reduce your risk of secondary polycythemia by not smoking.
All material copyright MediResource Inc. 1996 – 2024. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/condition/getcondition/Polycythemia
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