Talk:Polycythemia

Sonia Mirza

Can anybody please reply..

Polycythemia: Is it incurable? Is it a dangerous disease? It has any relation to cancer? and what is the drug of choise in both primary and secondry polycythemia?

hi . can anyone answer this question: i have taken 100 mg of elemental iron for approx one month and ended up having a hemoglobin level of 190 (normal is 140 to 160)for a male....is this secondary polycythemia and i am at risk of blood clots and how long before it returns to normal?

onerunnerone —Preceding unsigned comment added by Onerunnerwon (talk • contribs) 10:11, 14 October 2009 (UTC)

JAK2

We should put a reference to the Baxter paper on this page as well. JFW | T@lk 00:34, 26 December 2005 (UTC)

Done! I also included a reference to Levine et al. as well (full disclosure...I have worked with him before!). Andrew73 02:32, 26 December 2005 (UTC)

Name

rubra ? vera ?
Can someone explain what the 'vera' and 'rubra' in "polycythemia vera" and "polycythemia rubra vera" mean, please ? Are these Latin words ? Thanks. -- PFHLai 12:18, 2004 Jun 28 (UTC)

Polycythemia is made from 3 Greek words. Poly (many), cyto (hollow vessel or cell), & hema (blood) as it's a disease of too many blood cells. Polycythemia vera rubra is one type of this disease & vera is Latin for 'true' & rubra for 'red' since persons with this disease often show an unusually ruddy complexion. Most medical terminology is Greek or Latin derived from the Greek word.

Also clarification, the different names are used interchangebly, as: ploycythemia rubra = polycythemia vera = polycythemia rubra vera. Gaviidae 20:44, 20 December 2006 (UTC)

Calling for an expert

This article contains errors. Primary polycythemia cannot be caused by kidney tumours - that would be secondary polycythemia. Can an expert in this area please fix up this fundamental mistake. Thanks in advance.

--Quite right that polycythemia vera is caused by myoelodysplasia and not excess Epo. I'll make that edit, however some portions of the rest of the article probably need a touch of review in the future. Bdolcourt 14:44, 30 August 2006 (UTC)

polycythemia ruba vera is secondary polycythemia and has an underlying cause such as sleep apnea copd or anything that causes a rise in epo and is treatable by treating the underlying cause. polycythemia vera known as primary polycythemia has no secondary causes that can be found your oxygen levels are normal and you epo is normal or low. — Preceding unsigned comment added by 68.44.223.149 (talk) 07:54, 13 December 2011 (UTC)

Altitude

The page says that people who live at high altitudes can get polycythemia, and listed 4275 to 5200 meters. I've removed the elevations because I KNOW that there are a number of occurances in Leadville, Colorado, which is about 3100m. Furthermore, the top end of 5200 seems kind of arbitrary. Wenzhuan is at 5100 meters, but that doesn't mean that elevations above that are no longer 'high altitude' or that people don't live any higher than that. --Mdwyer 23:04, 18 August 2006 (UTC)

MISDIAGNOSIS…..We should add this category…

Polycythemia can be misdiagnosed for simple long term dehydration, I am a living example. Not consuming enough liquids in combination of consuming common diuretic such as; coffee, smoking and Alcohol can produce a CBC that will lead many experienced family doctors and Hematologist to a diagnosis of “Stress Polythemia”, or in my case the highest diagnosis of Polythemia Vera.

A MCV above 100 will typically indicate Alcohol abuse of some sort and the enlargement of Red Blood Cells. Most importantly, a JAK2 test is mandatory in the proper diagnosis of Polycythemia.

After three months with the rejection of Alcohol, Smoking, Coffee and the addition of massive liquids, my CBC is normal.

Improvements

I'd propose making the page primarily about polycythemia vera - the secondary causes are of little clinical significance, except insofar as they need to be distinguished from primary P. vera. It would probably be worth expanding the diagnostic algorithm for working up polycythemia and making such a distinction. There are some parts of the article that I'd like to work on in the near future - for example, P. vera can be cured (with stem cell transplantation). It's rarely done except for spent-phase disease, though. The possibility of transformation to spent-phase (myelofibrotic) disease or AML could be mentioned. Also, describing it as "non-fatal" isn't quite accurate; there's data to suggest that P. vera shortens life expectancy, and complications of P.vera (e.g. stroke, malignant transformation) can certainly be fatal. MastCell 01:58, 25 November 2006 (UTC)

Weight gain

I recently met someone who must have regular trips to the phlebotomist because she "makes too much blood." Sounded to me like polycythemia... except that they discovered she had it when she visited her doctor because of unexplained weight gain. After treatment began (solely the bloodletting) her weight vanished. This is apparently NOT a known symptom, and she had no tumors (pituitary or whatnot)... can anyone lead me to what similar diseases are out there that mimic polycythemia? One that somehow effects weight? She doesn't speak English well-enough to explain better. Gaviidae 20:31, 20 December 2006 (UTC)

No, weight gain is not a common symptom of polycythemia vera. In general, unfortunately, Wikipedia is not a great place to get medical advice. Probably best to discuss (or have your friend discuss) with her doctor. MastCell 22:08, 20 December 2006 (UTC)

I have heard of a kind of a spiraling syndrome where excessive weight contributes to sleep apnea, which then contributes to polycythemia. In this case, the cause and effect are reversed, but there might still be something to it. Again, however, you would need to talk to a real doctor. --Mdwyer 00:21, 22 December 2006 (UTC)

Treatment

What about anticoagulant therapy? It can be used. [[TheAngriestPharmacist]] 04:59, 3 May 2007 (UTC)

I did a little quick PubMed search. No trials seem to have been performed. There is little doubt that thrombotic events are an indication for long-term anticoagulation, at least until the condition is properly treated. Budd-Chiari syndrome, for instance, is generally treated with indefinite anticoagulation. JFW | T@lk 14:03, 3 May 2007 (UTC)

Agreed... low-dose aspirin is commonly used prophylactically, but anticoagulants are typically reserved for treatment of demonstrated clotting events. MastCell ^Talk 16:32, 3 May 2007 (UTC)

Target hematocrit

I removed the sentence about phlebotomy being reserved for hematocrits of >55-60 or demonstrated thrombotic events. In p. vera, phlebotomy is usually performed pre-emptively to bring the Hct down below 45 (for men) or below 42 (for women) - see PMID 11830459, for example. However, you're right about secondary polycythemia - it's much more of a gray area, and most people wouldn't phlebotomize unless the hematocrit was extreme or there were demonstrated thrombotic events (as the biology of secondary polycythemia is quite different from that of p vera or other myeloproliferative disorders). This is more of a practice-point/expert opinion thing, so it's hard to find a good reference for. MastCell ^Talk 16:43, 3 May 2007 (UTC)

JAK2 mutation and treatment for primary polycythemia

Will someone edit the article to include information regarding the JAK 2 mutation? Until recently, there has been no actual treatment because the mutation that causes polycythemia had not been identified. There is a clinical trial in Phase I going on at UCLA Medical Center and a safety study in progress at UCSF and a few other places in the United States. The information can be found at www.clinicaltrials.gov. The medication being studied in the trial-XL019-represents the first treatment for the disease rather than symptom management. My experience with primary polycythemia has involved polypharmacy (including hydorxyurea, anegrelide, plavix, and asprin) after a splenectomy and the phlebotomies became ineffective. --SJRN1 (talk) 22:34, 20 February 2008 (UTC)

Word of Caution for Therapeutic Blood Donations with the American Red Cross

I've given blood on several occasions to the American Red Cross to help those in need of blood as well as to help reduce the levels of hematocrit and hemoglobin. This was based on the advice of two doctors. At my last visit to the ARC, they put me on the indefinite ban list for for giving blood because my reasons were not "entirely altruistic". My blood is perfectly fine (according to other Red Cross techs and two of my doctors) to donate, but due to the "altruistic" clause, the ARC no longer accepts my otherwise useful blood. Beware of off-handedly disclosing this condition to the ARC (unless it's a serious condition that warrants disclosure) unless you want people to die from lack of available blood for transfusions (as well from helping yourself lower your RBC). There is another option if you disclose this, but they'll charge you $60 and make you get a doctor's formal prescription. Autocorrelation (talk) 21:15, 14 August 2009 (UTC)

As the result of delayed umbilical cord clamping

In JAMA 2007;297(11):1257-1258, "Timing of Umbilical Cord Clamping at Birth in Full-term Infants" speaks of polycythemia that results from delayed umbilical cord clamping. Should a section for neonates be added to this article?LCP (talk) what is the drug of choise in both primary and secondry polycythemia? —Preceding unsigned comment added by 119.155.105.163 (talk) 17:30, 24 January 2010 (UTC)

Glad to know

It is great to know that there is an emergency treatment. Of course I didn't read it was abnormal, nor a problem. Did I miss something? How about something like polycythemia is an abnormal condition (description here) which can lead to (description here) if not treated. Common symptoms are (descritpion here). I don't beleive this is too much to ask.216.96.76.166 (talk) 23:21, 5 January 2013 (UTC)

Why does "erythrocythemia" redirect here?

Term not used in article. Is it a synonym? 86.130.41.222 (talk) 16:22, 16 September 2014 (UTC)

About that, the article claims that "polycythemia refers to any increase in red blood cells, whereas erythrocytosis only refers to a documented increase of red cell mass." It is hard to differ between the terms with this sentence's definitions. Additionally, I don't believe it is accurate. Polycythemia refers to any increase in blood cells (erythrocytes, leukocytes, thrombocytes) according to several sources. — Preceding unsigned comment added by HrEkstedt (talk • contribs) 09:29, 26 April 2016 (UTC)

References

Polycythemia (also known as polycythaemia or polyglobulia)

No, its not! Polyglobulia is NOT a synonym for Polycythemia this costed me a point thanks wikipedia! --89.173.210.193 (talk) 17:07, 24 October 2016 (UTC)

Wiki Education assignment: WikiMed Oct-Nov 2022 UCSF SOM

This article was the subject of a Wiki Education Foundation-supported course assignment, between 25 October 2022 and 20 November 2022. Further details are available on the course page. Student editor(s): GP2b3a (article contribs).

— Assignment last updated by GP2b3a (talk) 17:35, 27 October 2022 (UTC)

Workplan:

Wed 11/2, WP-WIP #2

• Complete citations for sections “Absolute Polycythemia”
• Add discussion on standard workup for polycythemia

Wed 11/9, WP-WIP #3

• Add to Symptoms section (reformat to be consistent with Wiki manual of style)
• Add “Epidemiology” and “Treatment” section
• Add “History” to existing notable people section

Mon 11/14, WP-WIP #4

• Revise lead section to include most salient information upfront, update diagram if possible
• Check whole article for jargon and reduce as appropriate
• Receive peer review feedback

Fri 11/18, Course Wrap-up

• Edits based on peer review feedback
• Organize thoughts on ways the article could improve further

GP2b3a (talk) 16:02, 28 October 2022 (UTC)

Given that polycythemia is an objective laboratory finding most consistent with "Sign or Symptom" rather than 1 specific disease, will follow Wikiproject Med manual of style:

• Definition (current definitions)
• Differential diagnoses
• Pathophysiology or Mechanism
• Diagnostic approach or Evaluation
• Treatment or Management (for the symptom itself, if any: e.g., analgesics for pain)
• Epidemiology (incidence, prevalence, risk factors)
• History (of the science, not of the patient: e.g., "The oldest surviving description is in a medical text written by Avicenna.")
• Society and culture (e.g., cachexia was a literary symbol for tuberculosis in the 19th century and for AIDS in the 1980s.)
• Research (Is anything important being done?)
• Other animals

GP2b3a (talk) 20:08, 2 November 2022 (UTC)

While treatment varies significantly based on cause of polycythemia, would consider adding a "management" section to discuss the risk of thrombosis and also common management strategies other than phlebotomy. GP2b3a (talk) 18:29, 7 November 2022 (UTC)

Peer review of Oct-Nov 2022

•Complete citations for sections “Absolute Polycythemia" -> Major section complete, subsection under Ddx with one outstanding

•Add “History” to existing notable people section -> Incomplete

•Two things to continue: minimizing jargon, using simple and clear writing

•Two things to possibly consider for improvement: completing outstanding sections from to-do list, selecting a replacement picture/graphic

•Readability and flow –> basic ideas are introduced and appropriately expounded upon and given nuance

•Specific areas to fix –> “Absolute polycythemia” section, include a brief and basic explanation how/why there are different kinds of polycythemia to introduce concept of primary and secondary polycythemia, etc Justin Solarczyk (talk) 22:45, 9 November 2022 (UTC)

Thanks for your thoughtful peer review!

- I agree that we can continue to remove jargon from the text, which I've been working on this past week. I have also replaced the graphic. I changed the "notable people" section to one on athletic performance.

- The different kinds of polycythemia and their pathophysiology were previously explained in other parts of the article so I won't repeat in the "absolute polycythemia" section to avoid redundancy.

Possible future directions: Would appreciate if other wikipedians want to elaborate on athletic performance and polycythemia, and find reliable citations to substantial if EPO-stimulating agents/blood transfusions/athletic training affect athletic performance. Also consider including a diagram for diagnostic schema of polycythemia. GP2b3a (talk) 13:46, 17 November 2022 (UTC)

Hi there, my fiancé had been diagnosed with this condition at about the age of 36 he is now 39. Although there is no cure right now; It would be a true miracle for more possibilities of extending his life for his kids.

At the moment doing everything we can to minimise his suffering but would love to hear more about what is available in New Zealand hospitals as it is so hard for the ones that love him to see him this way.

Any clinical trials please contact me and I will let him know.

Thanking you sincerely. 49.224.79.182 (talk) 21:05, 7 June 2023 (UTC)