(Polycythemia Vera [PCV]; Polycythemia Rubra Vera [PRV]; Erythremia)
Polycythemia is a condition of the bone marrow. It makes too many red blood cells and platelets. Sometimes, white blood cells are affected. The increase of blood cells can cause the blood to thicken and clot.
There are many types. Each type has its own set of causes and risk factors. There is no exact cure. Early and proper care lowers the chances of serious problems.
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A mutation in certain genes causes polycythemia.
Your chances of polycythemia are higher:
- For men
- Those aged 40 years or older
- For people who are White
- If you are of Ashkenazi Jewish decent
The symptoms of polycythemia happen slowly. They differ from person to person. Some people show no signs of the condition. Polycythemia may cause:
- Itching after a warm or hot bath, shower, or any activity that requires soaking your skin in warm or hot water
- Weight loss
- Frequent bone pain or muscle pain
- Heavy bleeding from a simple cut or nosebleed
- Vision problems
- Ringing in the ears— tinnitus
- Breathing problems
- Reddish skin color
- Problems thinking
The doctor will ask about your symptoms and health history. Polycythemia is sometimes found by chance during a routine blood test.
You may have:
- A physical exam
- Blood tests
- Genetic tests
- Bone marrow biopsy to look for overproduction of cells or other problems
- Abdominal ultrasound to see if the spleen is enlarged
The tests can show the severity of the disease. This helps guide a care plan.
Care is based on severity of the disease. The goal is to control the course of the disease. This will help with managing problems caused by blood clots or bleeding. For some, a combination of methods works best.
Care may involve:
This technique allows a person to have blood removed at times. It lowers the amount of red blood cells. Phlebotomy is done when the levels get too high.
- Chemotherapy —Lowers blood cell production, controls blood volume, and improves your immune system.
- JAK inhibitors—Reduces spleen size and improves the balance of other blood cells.
- Low-dose aspirin—Thins blood to reduce the risk of blood clots. Don't take aspirin without talking to your doctor. It increases the risk of gastrointestinal bleeding.
Medicines can also help ease symptoms:
- Antihistamines or others to control itchy skin
- Pain relievers
- Allopurinol to reduce uric acid levels in the blood which can lead to gout
An enlarged spleen can be removed if it’s causing problems. Common problems are pain, pressure, or higher blood pressure in the liver. Your chances of certain infections are higher without a spleen.
There is no way to prevent polycythemia since the cause is unknown.
American Society of Hematology
National Heart, Lung, and Blood Institute
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Last reviewed May 2018 by EBSCO Medical Review Board Michael Fucci, DO, FACC Last Updated: 7/17/2018