POLYCYTHEMIA

POLYCYTHEMIA (Erythrocytosis) Types Relative (Normal RBC Mass / Decreased Plasma Volume) Burns Diarrhea Dehydration Idiopathic True (Elevated RBC Mass) JAK-2 Negative Elevated Erythropoietin Reactive (Most Common) Rule out exogenous cause of high EPO JAK-2 Positive Low/Normal Erythropoietin O₂ Saturation ≥ 90% Splenomegaly, Increased PMNs Polycythemia Vera Causes High Affinity Hemoglobin O₂ Saturation ≥ 90% Increased carboxyhemoglobin Abnormal P50 determination Smoking, positive family history, early onset Congenital Hemoglobinopathy Familial Polycythemia Carboxyhemoglobin Hypoxia O₂ Saturation ≤ 90% (Most Common) Erythropoietin Secreting Tumor O₂ Saturation ≥ 90% Abnormal Abdominal Ultrasound Exogenous Agents O₂ Saturation ≥ 90% Androgen/anabolic steroid use Recombinant EPO administration Associated Conditions Local Hypoxia (Normal O₂ Saturation) Renal Artery Stenosis Heart Murmur, Cyanosis without Pulmonary Disease Cyanotic Heart Disease Abnormal Chest X-Ray, Shortness of Breath, Cough, Smoking, Snoring, Chronic Chest Symptoms Sleep Apnea Chronic Pulmonary Disease