Overview Of Polycythemia Vera
Polycythemia vera (PV) is a bone marrow disease that leads to an abnormal increase in the number of blood cells. The red blood cells are mostly affected.
Commonly Associated With
Primary polycythemia; Polycythemia rubra vera; Myeloproliferative disorder; Erythremia; Splenomegalic polycythemia; Vaquez’s disease; Osler’s disease; Polycythemia with chronic cyanosis; Erythrocytosis megalosplenica; Cryptogenic polycythemia
Causes Of Polycythemia Vera
PV is a disorder of the bone marrow. It mainly causes too many red blood cells to be produced. The numbers of white blood cells and platelets may also be higher than normal.
PV is a rare disorder that occurs more often in men than in women. It is not usually seen in people under age 40. The problem is often linked to a gene defect called JAK2V617F. The cause of this gene defect is unknown. This gene defect is not an inherited disorder.
Symptoms Of Polycythemia Vera
With PV, there are too many red blood cells in the body.
This results in very thick blood, which can’t flow through small blood vessels normally, leading to symptoms such as:
- Trouble breathing when lying down
- Bluish skin
- Feeling tired all the time
- Excess bleeding, such as bleeding into the skin
- Full feeling in the left upper abdomen (due to enlarged spleen)
- Itchiness, especially after a warm bath
- Red skin coloring, especially of the face
- Shortness of breath
- Symptoms of blood clots in veins near the skin surface (phlebitis)
- Vision problems
- Ringing in the ears (tinnitus)
- Joint pain
Exams & Tests
The health care provider will perform a physical exam for PV.
You may also have the following tests:
- Bone marrow biopsy
- Complete blood count with differential
- Comprehensive metabolic panel
- Erythropoietin level
- Genetic test for the JAK2V617F mutation
- Oxygen saturation of the blood
- Red blood cell mass
- Vitamin B12 level
PV may also affect the results of the following tests:
- Lactate dehydrogenase (LDH)
- Leukocyte alkaline phosphatase
- Platelet aggregation test
- Serum uric acid
Treatment Of Polycythemia Vera
The goal of treatment is to reduce the thickness of the blood and prevent bleeding and clotting problems.
A method called phlebotomy is used to decrease blood thickness. One unit of blood (about 1 pint, or 1/2 liter) is removed each week until the number of red blood cells drops. The treatment is continued as needed.
Medicines that may be used to treat PV include:
- Hydroxyurea reduces the number of red blood cells made by the bone marrow. This drug may be used when the numbers of other blood cell types are also high.
- Interferon to lower blood counts.
- Anagrelide to lower platelet counts.
- Ruxolitinib (Jakafi) to reduce the number of red blood cells and reduce an enlarged spleen. This drug is prescribed when hydroxyurea and other treatments have failed.
- Taking aspirin to reduce the risk of blood clots may be an option for some people. But, aspirin increases the risk of stomach bleeding.
Ultraviolet-B light therapy can reduce the severe itching some people experience.