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Science Behind Maca: A Traditional Crop from the Central Andes
Published in Raj K. Keservani, Anil K. Sharma, Rajesh K. Kesharwani, Nutraceuticals and Dietary Supplements, 2020
Gustavo F. Gonzales, Cinthya Vasquez-Velasquez, Dulce Esperanza Alarcón-Yaquetto
It is believed that maca is effective for anemia treatment mainly because it contents iron. A randomized, placebo-controlled trial showed that spray-dried hidroalcoholic maca extract did not have significant effects on hemoglobin concentration over a 12-week treatment. Furthermore, hemoglobin levels significantly diminished compared to placebo in high altitude natives (Gonzales-Arimborgo et al., 2016). This is important since, at highlands, excessive erythrocytosis is a highly prevalent condition characterized by excessively high hemoglobin levels and with implications in the quality of life of the patient (León-Velarde et al., 2005). Maca might be used to treat this condition.
Human Erythroenzymopathies Of The Anaerobic Embden-Meyerhof Glycolytic And Associated Pathways
Published in Ronald L. Nagel, Genetically Abnormal Red Cells, 2019
Ernst R. Jaffé, William N. Valentine
Although 2,3-DPGM deficiency has been inferred in other cases on the basis of indirect evidence and with puzzling features demanding reservations,18 studies in a kindred with unequivocally severe 2,3-DPGM deficiency in the proband appeared to define the syndrome.109,110 In the proband, 2,3-DPG was nearly undetectable, as were the activities of 2,3-DPGM and 2,3-DPGP, confirming that both activities resided in the same protein. The lack of 2,3-DPG shifted the hemoglobin oxygen dissociation curve in the direction of increased avidity for O2, thus diminishing the tissue delivery of O2 at any given partial pressure. The result was a compensatory increase in red cell mass and mild erythrocytosis, but complete lack of clinical manifestations.
Haematology
Published in Fazal-I-Akbar Danish, Essential Lists of Differential Diagnoses for MRCP with diagnostic hints, 2017
Erythrocytosis:1 Primary: a Polycythaemia vera.2 Secondary: a Pathologic increase in erythropoietin (hypernephroma; ADPKD; transplant kidney; phaeochromocytoma; hepatoma; ovarian fibroma; cerebellar haemangioblastoma [part of von Hippel–Lindau’s syndrome]).b ↓ 02 in blood → physiologic increase in erythropoietin (high altitude; lung pathology; smoking [carboxyhaemoglobin]; cyanotic heart disease).
Secondary erythrocytosis
Published in Expert Review of Hematology, 2023
Rodrick Babakhanlou, Srdan Verstovsek, Naveen Pemmaraju, Cristhiam M. Rojas-Hernandez
Once repeat full blood count has confirmed the presence of erythrocytosis, and identification of the underlying etiology is important. While measurements of serum both EPO levels and JAK2 V617F and exon 12 mutation have been recommended to differentiate between primary or secondary erythrocytosis, this approach has turned out to be more complex than initially believed [7,11,14,20–23]. It was believed that in primary erythrocytosis the EPO levels would be below the normal range, while an inappropriately elevated EPO level was supportive of a secondary erythrocytosis [7,11]. Moreover, it was proposed that the presence of JAK2V617F and exon 12 mutation excluded secondary erythrocytosis [22]. It is important to keep in mind that normal serum levels of EPO do not rule out PV, as 10–20% of patients with PV exhibit normal or elevated serum EPO levels [1]. Further on, some PV patients do not express a JAK2 mutation. Hence, purely relying on these parameters may lead to misleading results. However, PV diagnosis is based on the WHO criteria, which include subnormal EPO levels as a minor criterion, while considering bone marrow morphology as a major criterion for making the correct diagnosis, even in cases of JAK2-unmutated PV [5].
The Gaisbock syndrome after COVID-19 pneumonia
Published in Baylor University Medical Center Proceedings, 2022
Abbie Evans, Busara Songtanin, Kenneth Nugent
Erythrocytosis has been associated with cardiovascular morbidity (odds ratio 1.8), cardiovascular mortality (hazard ratio 2.2), and all-cause mortality (hazard ratio 1.7).5 A longitudinal study investigating cardiovascular events in adults reported that men between 65 and 95 years old with elevated hematocrit (49%–70%) had a higher risk of death due to congestive heart failure, coronary heart disease, intermittent claudication, and stroke.6 In addition, documented cases have shown life-threatening thrombotic events, such as myocardial infarction and pulmonary embolism, in patients <40 years old with relative erythrocytosis.7 This emphasizes the importance of recognizing erythrocytosis and investigating the underlying cause. Although first described in 1905, Gaisbock syndrome remains clinically relevant today.
A New High Affinity Hemoglobin Variant: Hb San Francisco-KP (HBB: c.104T>C)
Published in Hemoglobin, 2021
Jahan Tavakoli, Gwendolyn Ho, Juraj Kavecansky, Ashok P. Pai
Polycythemia has numerous etiologies, with either secondary or primary polycythemia being the most common diagnosis. At times in clinical practice, no specific etiology is identified, and patients are managed with intermittent phlebotomy for ongoing symptoms, based upon a presumed diagnosis of idiopathic erythrocytosis. A more in-depth evaluation as to the etiology of polycythemia is crucial given the implications for management of patients, as well as their family members. Typically, polycythemia due to high oxygen affinity Hbs are well-tolerated and asymptomatic. However, there are reports of thrombotic phenomenon and symptoms of hyperviscosity improving with phlebotomy in some variants [10]. It is unknown what the optimal target PCV concentration is for these patients, and while asymptomatic individuals are not usually phlebotomized, patients with symptoms of hyperviscosity should have their PCV values reduced to between 0.60 and 0.52 L/L, or to a level where symptoms improve [11]. A unique feature of Hb San Francisco-KP is its association with symptoms at lower than expected PCV levels for patients with an altered affinity Hb. This led to the utilization of a phlebotomy goal of 0.45, the level at which the patient noted alleviation of his symptoms. It is important that phlebotomy be performed judiciously and target the highest possible Hb value given the underlying compensatory mechanism of the erythrocytosis.