Polycythemia
Background
- AKA erythrocytosis
- Refers to abnormally elevated Hb/Hct
Clinical Features
- Dependant on underlying etiology
- May be entirely asymptomatic
- Possible features include plethora, tendency towards thromboembolism or bleeding, splenomegaly, pruritus
Differential Diagnosis
- Primary polycythemia (myeloproliferative disorders)
- Secondary polycythemia (due to increased EPO)
- Chronic hypoxemia (e.g. COPD, physiologic altitude adaptations or chronic mountain sickness)
- Carboxyhemoglobin (chronic smokers)
- Renal cyst or hydronephrosis
- EPO-secreting tumors (RCC, hepatocellular carcinoma
- Anabolic steroid abuse
- Abnormal hemoglobins
Evaluation
- CBC
- Hb >17.5 (males) or >15.5 (females)
- Evaluate for underlying disease
Management
- Treat underlying pathology