Cause Of High Red Blood Cell Count – Polycythemia (also known as polycythemia) is a laboratory test in which the hematocrit (the percentage of red blood cells in the blood) and/or hemoglobin are increased in the blood. Polycythemia is sometimes called erythrocytosis, and there is more to the two studies, but the terms are not the same: polycythemia means an increase in hematocrit and/or hemoglobin, while erythrocytosis means an increase in the number of red blood cells in the blood.

Complete polycythemia can be caused by a mutation in the bone marrow (“primary polycythemia”), a combination of physiological conditions and human viruses, drugs, and/or lifestyle.

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Laboratory tests such as serum erythropoeitin levels and genetic testing can help clarify the cause of polycythemia if a physical exam and patient history do not reveal a possible cause.

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Mild polycythemia alone is often asymptomatic. Treatment for polycythemia varies, and usually involves treating the underlying cause.

Treatment of primary polycythemia (see polycythemia vera) may include phlebotomy, anticoagulants to reduce the risk of bleeding, and cytoreductive therapy to reduce the amount of red blood cells produced in the veins.

Polycythemia is defined as serum hematocrit (Hct) or hemoglobin (HgB) exceeding the normal range for age and sex, usually Hct > 49% in adults and > 48% in women, or HgB > 16.5g/dL in m or > 16.0g/dL in the womb.

A variety of diseases or conditions can cause polycythemia in adults. These processes are discussed in more detail in their respective sections below.

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Polycythemia is related not to a true increase in red blood cells or hemoglobin in the blood, but to a high laboratory caused by a decrease in blood plasma (hypovolemia, cf dehydration). Polycythemia is often caused by loss of body fluids, such as burns, dehydration, and stress.

A special type of polycythemia is Gaisböck’s syndrome. In this syndrome, especially found in obesity m, hypertsion causes a decrease in plasma volume, causing (among other changes) a relative increase in the number of red blood cells.

If moderate polycythemia is considered unlikely because the patient has no other symptoms of hemoconcentration, and he continues to have polycythemia without complete dehydration, the patient may have complete or true polycythemia.

Polycythemia in newborns is defined as a hematocrit >65%. Severe polycythemia may be associated with hyperviscosity of the blood, or blood clots. Causes of neonatal polycythemia include:

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The pathophysiology of polycythemia varies depending on its cause. Red blood cell production (or erythropoiesis) in the body is controlled by erythropoietin, which is a protein produced by the kidneys in response to oxygen deficiency.

Because of this, erythropoietin is produced more to make red blood cells and increase their oxygen-carrying capacity. This results in secondary polycythemia, which may be an appropriate response to hypoxic conditions such as chronic smoking, sleep deprivation, and high altitude.

In addition, certain diseases can interfere with the body’s ability to accurately detect the level of oxygen in the serum, which leads to excessive production of erythropoietin without hypoxia or impaired oxygenation of the tissues.

Also, some types of cancer, especially squamous cell carcinoma, and drugs such as testosterone use can cause abnormal production of erythropoietin that causes red cell production despite adequate oxygenation.

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On the other hand, primary polycythemia, caused by partial changes or defects in red blood cells from the bone marrow, leads to excessive growth and proliferation of red blood cells regardless of erythropoietin levels.

An increase in hematocrit and red blood cell count with polycythemia increases the quality of the blood, leading to poor blood circulation and a greater risk of infection (thrombosis).

The first step in diagnosing new polycythemia in any individual is to perform a detailed history and physical exam.

Patients should be questioned about smoking history, altitude, medication use, personal bleeding and wear history, sleep symptoms (snoring, epneic episodes), and any family history of hematologic or polycythemia. A complete heart and lung examination including auscultation of the heart and lungs can help diagnose heart disease or chronic disease. A pelvic exam can diagnose splomegaly, which may be present in polycythemia vera. Physical examination of erythromelalgia, clubbing or cyanosis may help diagnose chronic hypoxia.

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Polycythemia is often measured by a complete blood count (CBC). A CBC is often repeated to diagnose persistent polycythemia.

Primary polycythemia is a myeloproliferative disorder that affects the red blood cells in the bloodstream. Polycythemia vera (PCV) (a.

Often, more white blood cells and platelets are also produced. The hallmark of polycythemia vera is a high hematocrit, with Hct >55% in 83%.

The somatic (non-inherited) mutation (V617F) in the JAK2 gene, and in other myeloproliferative disorders, is present in 95%.

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Symptoms include headache and vertigo, and physical examination symptoms include an abnormally large back and/or liver. In some cases, infected people may have related problems including high blood pressure or blood clotting. Conversion to acute leukemia is rare. Phlebotomy is the mainstay of treatment.

Primary familial polycythemia, also known as primary familial and congital polycythemia (PFCP), occurs as a hereditary condition, unlike the myeloproliferative changes associated with acquired PCV. In many families, PFCP is caused by an autosomal dominant mutation in the EPOR erythropoietin receptor gene.

PFCP can cause an increase of up to 50% in the oxygen carrying capacity of the blood; skier Eero Mäntyranta had a PFCP, which is said to have given him an advantage in endurance.

Secondary polycythemia is caused by a natural or artificial increase in the production of erythropoietin, hce the production of erythrocytes.

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Secondary polycythemia in which the production of erythropoietin is increased appropriately is called physiologic polycythemia. Factors that can cause physiologic polycythemia include:

Conditions where secondary polycythemia is not caused by physiological conditions, and occurs regardless of the body’s needs:

Rarely inherited mutations in all three genes cause an increase in hypoxia-inducible sensitivity, resulting in increased erythropoietin production, which has been shown to cause secondary polycythemia:

Polycythemia is not common; patits cannot test any visible signs until the red color is intense. For patients with severe elevations in hemoglobin or hematocrit (usually from polycythemia vera), some unusual symptoms include:

Blood Clinical Corellaions

The prevalence of primary polycythemia (polycythemia vera) is estimated to be 44-57 per 100,000 people in the United States.

In one study using the NHANES dataset, the prevalence of unexplained erythrocytosis was 35.1 per 100,000, and was higher in men and in women aged 50-59 and 60-69.

Polycythemia is thought to increase performance in endurance sports because the blood is able to store more oxygen.

This theory has led to the illegal use of blood transfusions and transfusions in professional athletes, as well as the use of altitude training or altitude training masks to simulate low oxygen levels. However, the suitability of altitude training for athletes to improve cardiovascular performance is not universally accepted, because one of the reasons is that athletes at altitude may use less energy during exercise. Hematocrit (HCT) is a measure of ‘red blood cells (RBCs) in human blood. Adults with XY chromosomes typically have an HCT between 40% and 54%, and adults with XX chromosomes have an HCT between 36% and 48%. In addition to RBCs, blood contains three other important components: white blood cells, platelets, and plasma.

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Hematocrit measures the percentage of red blood cells in the blood volume. A hematocrit test can be performed using a capillary tube and a centrifuge (ie, a machine that uses centrifugal force to separate blood components due to different densities). Usually, the hematocrit level is seen as part of a complete blood count (CBC), but it can also be tested on its own. However, the CBC is the most common blood test for HCT as it also measures the red blood cell count, white blood cell count, hemoglobin level, and platelet count.

Hematocrit is a very useful laboratory because having too few or too many RBCs can be a clinical sign of various medical conditions, such as anemia or polycythemia. It can also be used to monitor people after treatment to prevent or detect complications, such as internal bleeding.

A low hematocrit level, also known as anemia, can be caused by decreased production of RBCs, increased blood flow, increased RBC count, or clotting.

The most common causes of high hematocrit are chronic (eg, ulcers, colon cancer) or severe bleeding (eg, trauma, internal bleeding), which causes a person to lose a lot of blood. Apparently, people of reproductive age who are assigned a female at birth can have a low hematocrit due to menstruation. However, the hematocrit can also decrease due to the destruction of RBCs as seen in conditions such as sickle cell anemia, where RBCs have a short life span; and splenomegaly (ie, enlargement of the spleen), where large numbers of healthy RBCs are destroyed in the spleen. Another reason for a low hematocrit is a decrease in RBC production, as seen in chronic kidney disease, or bone loss caused by radiation therapy, malignancy, or drugs such as chemotherapy. Finally, nutritional deficiencies (eg, iron, B12, and folate deficiencies)

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