Polycythemia
Revision as of 18:50, 15 March 2018 by Warner-admin (talk | contribs) (Text replacement - "'''Use of this site is subject to you reading and agreeing with the terms set forth in the disclaimer. If this is your first time visiting, we suggest you read the tutorial.'''" to "<!--'''Use of this site is subject to you reading and agreeing with the terms set forth in the disclaimer. If this is your first time visiting, we suggest you read the tutorial.'''-->")
Initial evaluation
May consist of:
- CBC with differential
- Pulse oximetry
- Serum erythropoetin
- JAK2 (V617F, exon 12 mutation)
- Comprehensive metabolic panel (CMP)
- Reticulocyte count
- Iron, total iron binding capacity (TIBC), ferritin
- Clinical history of arterial or venous thromboembolism (VTE), stroke, post-bathing pruritis, facial plethora, headache, fatigue, visual changes
Secondary polycythemia?
- Smoking
- Chronic lung disease
- Obstructive sleep apnea (OSA)
- Carbon monoxide (CO) exposure
- Home heating: natural gas or oil?
- Carbon monoxide detectors?
- Carboxyhemoglobin
- High altitude environments
- Testosterone use
- Erythropoetin use
- Athletic blood doping/transfusions
- Right to left cardiac shunt
- Dehydration/diuretic use
Additional considerations
- Renal ultrasound or other imaging to evaluate for erythropoetin-secreting renal tumor, pheochromocytoma
- Chest x-ray
- Urinalysis
- Family history of high oxygen affinity hemoglobinopathies?
- Cushing's syndrome?
- Congenital polycythemia?