What Does Elevated Hemoglobin And Hematocrit Mean – Polycythemia (also called polycythemia) is a laboratory finding in which the hematocrit (the amount of red blood cells perctage in the blood) and/or hemoglobin concentrations are elevated in the blood. Polycythemia is sometimes called erythrocytosis, and there is significant overlap in the two findings, but the terms are not the same: polycythemia describes any increase in hematocrit and/or hemoglobin, while erythrocytosis specifically describes an increase in the number of red blood cells. the blood
Complete polycythemia can be caused by genetic mutations in the bone marrow (“primary polycythemia”), physical changes in one’s vironmt, medications, and/or other health conditions.
- 1 What Does Elevated Hemoglobin And Hematocrit Mean
- 2 Hematocrit (hct) Blood Test: High Vs. Low Levels
- 3 What Is Hgb In Blood Test Results?
- 4 Recurrent Anemia In A Patient With Chronic Lymphocytic Leukemia
- 5 Hemoglobin (hbg) Lab Values
- 6 Point Of Care Testing Of Plasma Free Hemoglobin And Hematocrit For Mechanical Circulatory Support
What Does Elevated Hemoglobin And Hematocrit Mean
Laboratory studies such as serum erythropoietin levels and genetic tests may be useful in clarifying the cause of polycythemia if physical examination and pat history do not reveal a possible cause.
Hgb Blood Test: Why It’s Done And What It Can Show
Mild polycythemia itself is often asymptomatic. Treatment for polycythemia varies, and usually involves treating its underlying cause.
Treatment of primary polycythemia (see polycythemia vera) may include phlebotomy, antiplatelet therapy to reduce the risk of blood clotting, and additional cytoreductive therapy to reduce the number of red blood cells produced in the bone marrow.
Polycythemia is defined as a serum hematocrit (Hct) or hemoglobin (HgB) that exceeds the normal range expected for age and sex, typically Hct > 49% in healthy adults m and > 48%, or HgB > 16.5g/dL in m or >. 16.0g/dL in women.
Various diseases or conditions can cause polycythemia in adults. These processes are discussed in more detail in their respective sections below.
Hematocrit (hct) Blood Test: High Vs. Low Levels
Relative polycythemia is not an actual increase in the number of red blood cells or hemoglobin in the blood, but rather an elevated laboratory finding caused by blood plasma (hypovolemia, cf. dehydration). Relative polycythemia is often caused by loss of body fluids, such as burns, dehydration, and stress.
A specific type of relative polycythemia is Gasboc syndrome. In this syndrome, occurring mainly in obese M, hypertension reduces plasma volume, resulting (among other changes) in a relative increase in the number of red blood cells.
If relative polycythemia is considered unlikely because the pat has no other signs of hemoconcentration, and the polycythemia persists without obvious loss of body fluid, the pat may have absolute or true polycythemia.
Polycythemia in newborns is defined as a hematocrit > 65%. Significant polycythemia may be associated with blood hyperviscosity, or blood thickening. Causes of neonatal polycythemia include:
Back To The Basics: Blood Disorders
The pathophysiology of polycythemia varies depending on its cause. The body’s production of red blood cells (or erythropoiesis) is regulated by erythropoietin, a protein produced by the kidneys in response to poor oxygen delivery.
As a result, more erythropoietin is produced to encourage red blood cell production and increase oxygen-carrying capacity. This results in secondary polycythemia, which may be an appropriate response to hypoxic conditions such as chronic smoking, obstructive sleep apnea, and high altitude.
Furthermore, certain metabolic conditions can impair the body’s accurate detection of serum oxygen levels, leading to excessive erythropoietin production without hypoxia or impaired oxygen delivery to tissues.
Alternatively, some types of cancer, particularly squamous cell carcinoma, and medications such as testosterone use can cause inappropriate erythropoietin production that stimulates red cell production despite adequate oxygen delivery.
What Is Hgb In Blood Test Results?
Primary polycythemia, on the other hand, is caused by genetic mutations or defects in red cell progenitors within the bone marrow, leading to overgrowth and hyperproliferation of red blood cells regardless of erythropoietin levels.
As hematocrit and red cell mass increase with polycythemia, blood viscosity increases, which impairs blood flow and contributes to an increased risk of clotting (thrombosis).
The first step in evaluating new polycythemia in any individual is to conduct a detailed history and physical examination.
Patients should be asked about smoking history, height, medication use, personal bleeding and clotting history, symptoms of sleep apnea (snoring, apneic episodes), and any family history of hematologic conditions or polycythemia. A complete cardiopulmonary examination, including auscultation of the heart and lungs, can help evaluate for cardiac shunting or chronic pulmonary disease. Abdominal examination can evaluate for splenomegaly, which can occur in polycythemia vera. Examination of the digits for erythromelalgia, clubbing or cyanosis can help evaluate for chronic hypoxia.
Recurrent Anemia In A Patient With Chronic Lymphocytic Leukemia
Polycythemia is often initially identified on a complete blood count (CBC). The CBC is often repeated to evaluate for persistent polycythemia.
Primary polycythemias are myeloproliferative diseases affecting red blood cell precursors in the bone marrow. Polycythemia vera (PCV) (a.k.a. polycythemia rubra vera (PRV)) occurs when too many red blood cells are produced as a result of an abnormality in the bone marrow.
Often, extra white blood cells and platelets are also produced. Polycythemia vera is characterized by a high hematocrit, with Hct > 55% se in 83% of cases.
A somatic (non-inherited) mutation (V617F) in the JAK2 gene, also present in other myeloproliferative disorders, is found in 95% of cases.
Hemoglobin (hbg) Lab Values
Symptoms include headache and dizziness, and physical examination findings include an abnormally enlarged spleen and/or liver. In some cases, affected individuals may have conditions such as high blood pressure or blood clots. Transformation to acute leukemia is rare. Phlebotomy is the mainstay of treatment.
Primary familial polycythemia, also known as primary familial and congenital polycythemia (PFCP), exists as a largely inherited condition, in contrast to the myeloproliferative changes associated with acquired PCV. In many families, PFCP is caused by an autosomal dominant mutation in the EPOR erythropoietin receptor ge.
PFCP can increase the oxygen-carrying capacity of the blood by up to 50%; Skier Eero Mäntyranta had PFCP, which is believed to have given him an advantage in the Durance events.
Secondary polycythemia is due to a natural or artificial increase in the production of erythropoietin, an increased production of erythrocytes.
What Does High Hematocrit Mean?
Secondary polycythemia in which the production of erythropoietin is appropriately increased is called physiologic polycythemia. Conditions that can cause physiologic polycythemia include:
Conditions where secondary polycythemia is not due to physical adaptation, and arises regardless of the body’s needs:
Rare inherited mutations in three ges that increase the stability of hypoxia-inducible factors, which increase erythropoietin production, have been shown to cause secondary polycythemia:
Polycythemia is often asymptomatic; Patients may not experience any noticeable symptoms until the red cell count is very high. For patients with significant elevations in hemoglobin or hematocrit (often from polycythemia vera), some nonspecific symptoms include:
High Elevation And Blood Work: Why It Matters For Optimal Client Outcomes
The prevalence of primary polycythemia (polycythemia vera) was estimated to be approximately 44-57 per 100-000 persons in the United States.
In a study using the NHANES dataset, the prevalence of unexplained erythrocytosis was 35.1 per 100,000, and was higher in men and in individuals between 50–59 and 60–69 years of age.
Polycythemia is theorized to increase performance in endurance sports because the blood can store more oxygen.
This idea has led to the illegal use of blood doping and transfusions among professional athletes, as well as the use of altitude training or altitude training masks to simulate a low-oxygen environment. However, the benefits of altitude training for improving sea-level performance for athletes are not universally accepted, one reason being that athletes at altitude may use less force during training. High hemoglobin level is a symptom of many diseases. Here are seventeen of the most common causes of elevated hemoglobin levels.
A Prediction Rule To Guide Jak2 Testing In Patients With Suspected Polycythemia Vera
A high hemoglobin count confirms that your blood carries an above-average concentration of the oxygen-carrying compound hemoglobin. That’s not quite the same thing
, because red blood cells can carry different amounts of hemoglobin. It’s also not as high iron levels.
It is possible to have high iron levels due to hereditary hemochromatosis or beta-thalassemia but at the same time low hemoglobin levels due to red blood cell anemia. But it is possible to have high hemoglobin levels even with anemia .
Red blood cells that are bound to sugar groups. You may have a high HbA1C count but still have low hemoglobin levels because you are both diabetic and anemic. And diabetics can have artificially high HbA1C numbers because they have low hemoglobin or low red blood cell counts.
Red Blood Cells (erythrocytes)
. Hematocrit is the ratio of red blood cell volume to total blood volume. Because red blood cells do not contain the same amount of hemoglobin, the hematocrit does not tell you how much hemoglobin you have.
In the United States, most doctors will define high hemoglobin counts as more than 17.5 grams (g) per deciliter (dl) of blood for men, or 15.5 g/dl for women who are still menstruating. Low, normal, and high hemoglobin levels for children vary by age and gender.
Most of the rest of the world measures hemoglobin in millimoles (mmol) per liter (L). Hemoglobin level in mmol/L is much lower than hemoglobin level in g/dl. Outside the United States, “normal” hemoglobin values range from 9.6 mmol/L for women to 10.9 mmol/L for men. Children have higher hemoglobin levels than older children and adults.
Most of the data that lead to the current understanding of “average” hemoglobin levels actually come from studies of blood donors, who would be refused blood donations if their hemoglobin levels were too low. 
Point Of Care Testing Of Plasma Free Hemoglobin And Hematocrit For Mechanical Circulatory Support
There are no situations in which a doctor orders a hemoglobin test such as “I wonder if this patient is high.
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