Polycythemia vera: Difference between revisions
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**Pruritus after bathing | **Pruritus after bathing | ||
==Diagnostic Criteria<ref>Tefferi, A, et al. The 2008 World Health Organization classification system for myeloproliferative neoplasms: order out of chaos. Cancer. 2009; 115(17):3842-7,</ref>== | |||
*Criteria 1: All category A | |||
*Criteria 2: First 3 of category A and any 2 of category B | |||
{| class="wikitable" | |||
|- | |||
! Category A !! Category B | |||
|- | |||
| Increased RBC Mass (Men >18.5, Women >16.5) || Thrombocytosis (>400,000) | |||
|- | |||
| Normal SPO2 (>92%) || Leukocytosis (>12,000) | |||
|- | |||
| Splenomegaly ||Leukocyte Alk Phos >100 | |||
|- | |||
| || Vit B12 >900 | |||
|} | |||
==DDx== | ==DDx== | ||
*Essential thrombocytosis (ET) | *Essential thrombocytosis (ET) | ||
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==Sources== | ==Sources== | ||
http://emedicine.medscape.com/article/205114-differential | http://emedicine.medscape.com/article/205114-differential | ||
<references/> | |||
[[Category:Heme/Onc]] | [[Category:Heme/Onc]] | ||
Revision as of 14:53, 23 January 2015
Background
- Chronic myeloproliferative disorder
- Abnormal proliferation is seen in all 3 cell lines
- Typically in elderly
- Can be asymptomatic or symptomatic
Clinical Presentation
- Severe burning pain in the hands or feet accompanied by a reddish or bluish coloration of the skin
- Suspected with any combination of the following: [1]
- Abnormally elevated hemoglobin levels (>18 g/dL in men; 16 g/dL in women)
- Normal oxygen saturation
- Bleeding complications
- Portal vein thrombosis
- Splenomegaly
- Plethora
- Pruritus after bathing
Diagnostic Criteria[2]
- Criteria 1: All category A
- Criteria 2: First 3 of category A and any 2 of category B
| Category A | Category B |
|---|---|
| Increased RBC Mass (Men >18.5, Women >16.5) | Thrombocytosis (>400,000) |
| Normal SPO2 (>92%) | Leukocytosis (>12,000) |
| Splenomegaly | Leukocyte Alk Phos >100 |
| Vit B12 >900 |
DDx
- Essential thrombocytosis (ET)
- Chronic myelogenous leukemia (CML)
- Leukemoid reactions
- Hypoxia
Labs
- CBC
- Chem 7
- ESR
- EPO
- Bone Marrow Bx sometimes needed
Treatment
- Phlebotomy
- ASA 81 mg
- Myelosuppressive agents
Also See
Sources
http://emedicine.medscape.com/article/205114-differential
- ↑ http://emedicine.medscape.com/article/205114-differential
- ↑ Tefferi, A, et al. The 2008 World Health Organization classification system for myeloproliferative neoplasms: order out of chaos. Cancer. 2009; 115(17):3842-7,