Polycythemia vera

What is polycythemia vera?

Polycythemia vera is a disease in which the amount of red blood cells in the blood is increased. In this disease, hemoglobin, hematocrit, or red blood cell levels, when measured by a complete blood count, may be elevated compared to normal levels. Regarding hematocrit value greater than 48% in women and more than 52% in men is indicative of polycythemia vera.

What are the symptoms of polycythemia vera?

Symptoms vary widely. In some cases, the disease may be asymptomatic. When the increased concentration of blood cells is caused by another disease, then the symptoms are associated with the manifestations of the underlying disease.

What are the reasons?

The production of red blood cells – erythropoiesis takes place in the bone marrow and takes place in several specific stages. One of the most important enzymes that regulate this process is called erythropoietin /EPO/. Most of the EPO is produced and released by the kidneys and a smaller amount is released by the liver.

The disease may be the result of disturbances in the process of erythropoiesis. This is called primary polycythemia vera. If the clinical condition is caused by other diseases or conditions, it is considered secondary.

Most cases of the clinical condition are secondary and are caused by another disease. The primary form is very rare. From 1 to 5% of newborns can have an increased concentration of red blood cells in the blood.

Symptoms can be quite vague and confusing. Some of the most characteristic symptoms are:

• Easy bruising;
• Easy bleeding;
• Formation of blood clots – potentially leading to heart attacks, strokes, blood clots in the lungs /pulmonary embolism/;< /li>
• Bone and joint pain – hip and rib pain;
• Headache and itching;
• Itching after taking a shower or bath;
• Fatigue, dizziness and pain in the abdominal area;

Treatment of polycythemia vera

The main method of treatment remains bloodletting, so that the hematocrit remains 45% in men and 42% in women. Initially, it may be necessary to perform a phlebotomy every 2-3 days and remove 250 to 500 milliliters of blood with each procedure. Once the goal is achieved, bloodletting procedures can be done less frequently.

A medication called hydroxyurea is also often recommended. This is especially recommended for people who are prone to blood clot formation. If you are over 70 years old and have a platelet count higher than 1.5 million/thrombocytosis/ and the presence of cardiovascular diseases, the use of hydroxyurea is more favorable. The medication is also recommended for patients who cannot tolerate bloodletting. Hydroxyurea helps to reduce the amount of all blood cells, while phlebotomy only reduces the hematocrit.

Aspirin is also used for treatment to reduce the risk of blood clots. Its use is generally avoided in all cases where patients have had previous hemorrhages. Aspirin is usually used in combination with bloodletting.

When the cause of the disease is a violation of the erythropoiesis process, you can help yourself at home by:

• You should keep your body well hydrated to avoid further concentrating the blood due to dehydration.
• It is best to avoid foods containing iron as you can you stimulate the production of red blood cells.