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Polycythemia (Absolute= increases RBC mass (primary or secondary) (Tx…
Polycythemia
Absolute= increases RBC mass (primary or secondary)
Primary (polycythemia vera)
= myloproliferative disorder of pluripotent stem cells of the bone marrow
Uncontrolled synthesis of RBC
platelet and WBC are also affected (but lesser)
Median age= 60yo M>F
the JAK2 gene is mutated in many cases --> involved in the singling pathway of the EPO-receptor
Secondary (erythrocytosis)
=bone marrow hyperplasia caused by increased EPO levels
CAUSES
Prolonged hypoxia: compensation for high alt, COPD or CVD or heavy smoking
Inappropriate erythropoietin production: EPO-secreting tumour, conditions that obstruct blood flow to the kidneys
S&S
HTN, flushed face and skin, headache, dizziness, blurred vision, tinnitus, splenomegaly and hepatomegaly
Complications
R/o Thrombosis
Angina/ heart failure
r/o hemorrhage
Tx
Reduce blood viscosity
intentional bleeding
hydration therapy
marrow surpassing drugs
ASA
= a condition causing an abnormally high RBC mass and elevated Hct
Relative= hemoconcentration due to decreased plasma volume