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Polycythemia vera

Primary polycythemia; Polycythemia rubra vera; Myeloproliferative disorder; Erythremia; Splenomegalic polycythemia; Vaquez's disease; Osler's disease; Polycythemia with chronic cyanosis; Erythrocytosis megalosplenica; Cryptogenic polycythemia

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.

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Causes

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

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:

Exams and Tests

The health care provider will perform a physical exam. You may also have the following tests:

PV may also affect the results of the following tests:

Treatment

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 include:

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.

Support Groups

The following organizations are good resources for information on polycythemia vera:

Outlook (Prognosis)

PV usually develops slowly. Most people do not have symptoms related to the disease at the time of diagnosis. The condition is often diagnosed before severe symptoms occur.

Possible Complications

Complications of PV may include:

When to Contact a Medical Professional

Call your provider if symptoms of PV develop.

Related Information

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References

Kremyanskaya M, Najfeld V, Mascarenhas J, Hoffman R. The polycythemias. In: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 68.

National Cancer Institute website. Chronic myeloproliferative neoplasms treatment (PDQ) -- health professional version. www.cancer.gov/types/myeloproliferative/hp/chronic-treatment-pdq#link/_5. Updated February 1, 2019. Accessed March 1, 2019.

Tefferi A. Polycythemia vera, essential thrombocythemia, and primary myelofibrosis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 166.

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Review Date: 1/29/2019  

Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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