POLYCYTHEMIA

38 year old patient has been admitted for raised Hb,RBC .

Currently the patient is asymptomatic.

ON EXAMINATION

Jaundice: Nil Anemic:NilLN:NilCyanosis:NilClubbing:NilOedema:NilDehydration:Nil

VITALS:P:80/minBP:150/100mmHgR/R:20/minT:36.6cWt:102kg

CHEST: B/l clear air entry

CVS:S1.S2.M0

P/A:Soft nontender,no organomegaly

MEDICAL h/o:HTN+,no DM,PTB,Hepatitis

SURGICAL h/o:non significant

ALLERGIC h/O:non significant

PERSONAL h/o:Smoker X 10 years,alcoholic+

INVESTIGATIONS

COMPLETE BLOOD COUNT:

WBC:10.44X10*9/L(N=62.5%),L(29.3%),

RBC:6.56X10*12/L,HB:203g/L,HCT:60.2%

PLT:193X10*9/L

Random Blood Sugar:6.71mmol/L

RENAL FUNCTION TEST:

Urea:4.7mmol/L,Cr:78umol/L

Na:140mmol/L,K:3.78mmol/L

DIAGNOSIS

POLYCYTHEMIA

HYPERTENSION

INTRODUCTION

Polycythemia (also known as polycythaemia or polyglobulia) is a disease state in which the proportion of blood volume that is occupied by red blood cells increases.

Blood volume proportion can be measured by

HCT levels.

An increase in the number of red blood cells

Elevated hematocrit measurement

Elevated levels of hemoglobin

Very low levels of erythropoietin

TREATMENT

Phlebotomy

Low dose of ASPIRIN

Medication to decrease blood cells:

Hydroxyurea,IFN@

COMPLICATIONS

Blood Clots:Leading to risk of CVA,MI

Massive Splenomegaly

Itching of Skin

Other Blood Disorder:Myelofibrosis,MDS,Acute Leukemia

DEBATABLE POINTS

Why not to use Hydroxyurea ,IFN@?

Is it worthy sending serum EPO?

Random Blood Sugar is high,Patient is obese

to send Fasting Blood Sugar is a must?

While using ASPIRIN,PPI should be used to protect patient from Peptic Ulcer,UGI bleeding?

Reference

www.mayoclinic.orghttp://o.quizlet.com/i/ETrGKdDiTFnjmbW5FpU9xg_m.jpg

http://photos1.blogger.com/blogger/6305/3126/320/MRCP_polycythaemia.png

http://www.bloodjournal.org/content/bloodjournal/120/2/275/F3.large.jpg?sso-checked=true

THANK YOU