Peer Reviewed
Feature Article Haematology
A guide to the diagnosis of polycythaemia
Abstract
True polycythaemia needs to be distinguished from other causes of an elevated haemoglobin concentration. What tests are useful in the diagnosis and initial assessment?
Key Points
- True polycythaemia is a myeloproliferative disorder that needs to be distinguished from other causes of an elevated haemoglobin level. A reduction in the plasma volume (relative polycythaemia), an increase in erythropoietin secretion (secondary polycythaemia) and smoking (smoker’s polycythaemia) can all increase the haemoglobin level.
- If a patient’s haemoglobin level is borderline between normal and high, look for possible clinical causes such as dehydration or smoking. Remember that such findings may be normal in young males.
- A high haemoglobin level is more important if intercurrent vascular disease is present because polycythaemia vera is a risk factor for both arterial and venous thrombosis.
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