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Question
Posted by: Anon | 2004/01/22

Polycythaemia

My father's recent blood tests reflect the presence of polycythaemia. Could you provide me with: an explanation of the disorder, the concerns, implications and treatment thereof.

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Polycythaemia
The term polycythaemia refers to an increase in red blood cells reflected as an increase in haemoglobin or packed cell volume on the full blood count. Polycythaemia may develop due to a decrease in plasma volume (relative polycythaemia) or a true increase in the total red cell mass (absolute polycythaemia).

Relative polycythaemia is found in dehydration. Absolute polycythaemia may be primary or secondary. Primary polycythaemia refers to a clonal bone marrow disease. The bone marrow produces more red cells without a cause being found. In secondary polycythaemia there is a disease causing increase of erythropoietin (hormone that stimulates red cell production) which leads to an increase in red cell production by a normal bone marrow. In some cases the erythropoietin production is appropriate - for instance if somebody lives at very high altitudes it is necessary for the body to produce more red cells to carry oxygen (less oxygen available at higher altitudes). In other cases the erythropoietin production is inappropriate and is derived from a tumor producing erythropoietin.

The work – up of a patient presenting with polycythaemia should include the following:
Exclude relative polycythaemia. This is usually obvious form the physical examination. Exclude secondary causes of polycythaemia.
If the final diagnosis is a primary polycythaemia the treatment will consist of blood letting at certain intervals depending on how active the bone marrow produces red cells. If the polycythaemia cannot be controlled with blood letting the doctor will consider a mild form of chemotherapy.

The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.

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