Polycythemia is a medical condition which results in an increased amount of red blood cells (RBC) in the bloodstream. People with Polycythemia have a higher than normal levels of hemoglobin and hematocrit. Polycythemia is suspected when the hematocrit is more than 52 percent in men and 48 percent in women.
Polycythemia may be divided into two categories called primary and secondary Polycythemia.
Primary Polycythemia – Primary Polycythemia is characterized by an increase of RBC due to natural problems in red blood cell production.
Secondary Polycythemia – Secondary Polycythemia usually occurs in response to secondary illnesses and conditions which promote the production of red blood cells.
Causes of Polycythemia
Hypoxia (lack of oxygen in the body) caused from chronic lung disease and smoking are two common causes of Polycythemia. Chronic exposure to carbon monoxide can be a contributing factor for people working in underground parking garages, tunnels or extremely congested and polluted cities. Factory workers chronically exposed to engine exhaust and cab drivers may also be at risk for developing Polycythemia.
People living in high altitudes may also be at risk of developing Polycythemia due to low oxygen levels. There are less oxygen concentrations in higher altitudes, so the body will create more red blood cells in an attempt to capture more oxygen to bind with the hemoglobin within the RBCs. People who have inherited mutations and familial Polycythemia, or those who have hemoglobin irregularities may also be at risk for the condition.
Symptoms of Polycythemia
The symptoms of Polycythemia may be minimal in a lot of people. There are some common and non-specific symptoms associated with Polycythemia. Some of the symptoms of Polycythemia include:
Diagnosis of Polycythemia can be done by testing the blood (Complete Blood Count also called a CBC) for hematocrit, hemoglobin and red blood cell count. It may be necessary to repeat some of the lab tests to confirm the diagnoses and to rule out any possible laboratory errors.
A total physical examination with the assessment of vital signs, lung and heart exams, oxygen saturation, as well as an examination of the spleen are necessary to diagnose people with Polycythemia. Other tests include a chest X-ray, echocardiogram (ECHO), electrocardiogram (EKG or ECG) may be done to screen for heart disease or lung disease. A hemoglobin analysis may be required to rule out any other conditions which could cause the symptoms of Polycythemia. The major criteria for a diagnosis of Polycythemia are a hemoglobin level of more than 18.5 grams per deciliter for men and 16.5 grams per deciliter for women.
Treatment for Polycythemia
The treatment for Polycythemia may depend on the cause for the disorder. Phlebotomy is the most important part of the treatment, so that blood samples can be collected and evaluated. People who have Polycythemia may be at risk for forming blood clots due to the blood’s high viscosity. The medication, hydroxurea (a cancer drug that inhibits the excessive growth of blood cells – is used in leukemia and other cancers), is recommended for people having primary Polycythemia. If a patient with Polycythemia has a platelet count is more than 1.5 million, or has cardiovascular problems, hydroxurea may be one of the best medical treatment options.
Oftentimes, doctors will prescribe low dose aspirin as a viable treatment for Polycythemia, because aspirin causes the platelets to be less sticky, thereby reducing the viscosity of the blood. Aspirin can help prevent blood clots from forming. If the patient has bleeding problems, Aspirin might not be the best choice of treatment.
