Polycythaemia

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Definition

Too many red blood cells - an erythrocyte count of over 18g/dL.

Pathophysiology

Makes you more likely to have clots, and thus pulmonary embolism, MI and CVA.

Differential

  • Athletes taking EPO illegally, or living or training at high altitudes.
  • Renal tumours, and liver tumours can cause increased EPO release.
  • Polycythaemia vera - bone marrow production of too many red cells. Causes pruritus.
  • Renal transplant, giving three kidneys producing EPO.
  • Endocrine abnormalities.

Clinical Features

Generally none. Then a clot.

Investigations

FBC, which will show elevated haemoglobin.

Management

Acutely, the only way to reduce erythrocyte levels is to remove blood from the body, known as phlebotomy, or blood letting. Long term, you treat the cause of the polycythaemia.