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Myeloproliferative Disorders
Published in Harold R. Schumacher, William A. Rock, Sanford A. Stass, Handbook of Hematologic Pathology, 2019
Patients with secondary polycythemia usually exhibit physical and laboratory findings different from patients with PV. These include: Absence of splenomegalyAbsence of leukocytosis and/or thrombocytosisNormal LAP valueIn patients with chronic anoxia, arterial sO2 is ≥92%Patients with abnormal Hb may show abnormalities in oxygen dissociation curve (P50), Hb electrophoresis, or RBC enzymesBone marrow examination does not show the marked hypercellularity and megakaryocyte hyperplasia typical of PV
Rheology of Polycythemias T. C. Pearson
Published in Gordon D. O. Lowe, Clinical Blood Rheology, 2019
The number of patients with a vascular complication described in the literature is small, but they are significant since the remaining forms of secondary polycythemia are relatively uncommon. In seven cases of polycythemia following renal transplantation, four patients developed thrombo-embolic complications and two others had thrombotic episodes.46 In the exceedingly rare familial polycythemia due to autonomous erythropoietin production, an affected young child with a PCV of 0.72 had a stroke.47 Anecdotal reports of thrombotic events in other forms of secondary polycythemia have also been recorded. For example, a patient has been described as presenting a retinal artery occlusion, and on investigation was found to have polycythemia and a hypernephroma.48
Blood and hemostasis
Published in Laurie K. McCorry, Martin M. Zdanowicz, Cynthia Y. Gonnella, Essentials of Human Physiology and Pathophysiology for Pharmacy and Allied Health, 2019
Laurie K. McCorry, Martin M. Zdanowicz, Cynthia Y. Gonnella
Polycythemia is a disorder in which the number of red blood cells in circulation is greatly increased. There are two categories of polycythemia, relative and primary. Relative polycythemia results from an increase in the concentration of red blood cells due to a loss of plasma volume. In contrast, primary polycythemia (polycythemia vera) is caused by excessive proliferation of bone marrow stem cells. Polycythemia vera is a rare neoplastic disorder that occurs in men between the 40 and 60 years of age. A secondary form of polycythemia may occur from excess erythropoietin production as a physiologic response to hypoxia. Secondary polycythemia may be seen in individuals living at high altitudes, chronic smokers, or individuals with chronic obstructive pulmonary disease.
Association between polycythemia and risk of ischemic stroke in males based on the national health insurance service-health screening cohort
Published in Expert Review of Hematology, 2023
Hyo-Sun You, Sang-Jun Shin, Joungyoun Kim, Hee-Taik Kang
Hematologic disorders are common causes of ischemic stroke but are frequently neglected [3]. Polycythemia is a hematological disorder that can cause ischemic stroke. Polycythemia refers to a state in which the hematocrit or hemoglobin concentration in peripheral blood is increased. Polycythemia, or erythrocytosis, is classified into spurious polycythemia and true polycythemia according to its etiology. Spurious polycythemia is induced by volume contraction, severe dehydration, and Gaisbock syndrome. True polycythemia is divided into primary and secondary polycythemia according to serum erythropoietin (EPO) levels. Polycythemia vera and primary familial and congenital polycythemia are the types of primary polycythemia with low serum EPO levels. Secondary polycythemia is caused by various diseases that cause hypoxia in cells, which induces EPO release. High altitude, respiratory diseases such as chronic obstructive pulmonary disease (COPD), cyanotic heart disease, elevated carboxyhemoglobin, hemoglobinopathies, and EPO-secreting tumors can also cause secondary polycythemia [4].
Frequency of JAK2V617F, MPL and CALR driver mutations and associated clinical characteristics in a Norwegian patient cohort with myeloproliferative neoplasms
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2023
Susanne Lilleskare, Marta Vorland, Anh Khoi Vo, Aasne K. Aarsand, Håkon Reikvam
Investigation for a potential myeloproliferative neoplasm is typically initiated when abnormal laboratory test results for hemoglobin, leukocytes and/or platelets persist over time, or when a thromboembolic event has occurred. In our study population of 802 patients, 182 patients had received a myeloproliferative neoplasm diagnosis. Thus, less than 25% of the patients where molecular analyses had been performed, was diagnosed with a myeloproliferative neoplasm. That indicates that a large proportion of the patients who were assessed, had a secondary polycythemia or reactive thrombocytosis. Still, when there is suspicion of a myeloproliferative neoplasm, referral for investigation and diagnostics is important for assessment of treatment and measures to prevent thromboembolic events or bleeding, and presently driver mutation analysis is part of the diagnostic criteria.
A thrombotic event in a HeartMate 3 patient in the setting of secondary polycythemia
Published in Baylor University Medical Center Proceedings, 2022
Nausharwan Butt, Farooq H. Sheikh
The present case highlights a thrombotic event in a patient with LVAD therapy in the setting of polycythemia. Our patient had underlying secondary polycythemia with prior negative workup from primary causes (e.g., negative JAK2 mutation). Patients with polycythemia are at increased risk for thromboembolic events, which can cause significant morbidity and mortality.3 Our patient experienced an acute thrombotic event with associated hemolysis (as evidenced by elevation of LDH/plasma-free hemoglobin) and a non-ST-elevation myocardial infarction with a new coronary thrombus in the setting of worsening polycythemia.