Polycythemia vera: Difference between revisions
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*Can be asymptomatic or symptomatic | *Can be asymptomatic or symptomatic | ||
==Clinical | ==Clinical Features== | ||
*Severe burning pain in the hands or feet accompanied by a reddish or bluish coloration of the skin | *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: <ref>http://emedicine.medscape.com/article/205114-differential</ref> | *Suspected with any combination of the following: <ref>http://emedicine.medscape.com/article/205114-differential</ref> | ||
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**Pruritus after bathing | **Pruritus after bathing | ||
== | ==Differential Diagnosis== | ||
*Essential thrombocytosis (ET) | |||
*Chronic myelogenous leukemia (CML) | |||
*Leukemoid reactions | |||
*Hypoxia | |||
==Diagnosis== | |||
===Workup=== | |||
*CBC | |||
*Chem 7 | |||
*ESR | |||
*EPO | |||
*Bone Marrow Bx sometimes needed | |||
===Evaluation<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 1: All category A | ||
*Criteria 2: First 3 of category A and any 2 of category B | *Criteria 2: First 3 of category A and any 2 of category B | ||
| Line 32: | Line 47: | ||
| || Vit B12 >900 | | || Vit B12 >900 | ||
|} | |} | ||
==Treatment== | ==Treatment== | ||
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==Also See== | ==Also See== | ||
==References== | |||
== | |||
<references/> | <references/> | ||
[[Category:Heme/Onc]] | [[Category:Heme/Onc]] | ||
Revision as of 07:04, 29 August 2015
Background
- Chronic myeloproliferative disorder
- Abnormal proliferation is seen in all 3 cell lines
- Typically in elderly
- Can be asymptomatic or symptomatic
Clinical Features
- 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
Differential Diagnosis
- Essential thrombocytosis (ET)
- Chronic myelogenous leukemia (CML)
- Leukemoid reactions
- Hypoxia
Diagnosis
Workup
- CBC
- Chem 7
- ESR
- EPO
- Bone Marrow Bx sometimes needed
Evaluation[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 |
Treatment
- Phlebotomy
- ASA 81 mg
- Myelosuppressive agents (hydroxyurea, interferon alpha)
Also See
References
- ↑ 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,