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Polycythemia
Polycythemia vera is a blood disorder that occurs when the body's bone marrow produces too much red blood cells. Due to the over production of red blood cells, the blood thickens and makes it difficult for blood to flow. Without proper circulation, issues, such as blood clots or strokes, can arise. Polycythemia can be separated into two broad categories:
Primary polycythemia (PV): PV, also known as myeloproliferative neoplasm, is a rare, slow-growing cancer where the bone marrow behaves abnormally and creates an excess of red blood cells. In some instances, PV can also create an excess in white blood cells.
Secondary polycythemia: In secondary polycythemia, the increase in red blood cells occur from PV. These causes can be due to high elevations, sleep apnea, certain tumors, a heart or lung disease which causes low oxygen levels.
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Risk Factors
Polycythemia is not genetic, but patients with a family history of polycythemia are still encouraged to get testing as there are connections to genetic mutations such as Janus kincase (JAK2) and the TET2 gene, but the role the former genetic mutation is still unclear. As it stands, polycythemia is most common in men and people over the age of 60.
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Symptoms
PV symptoms might not appear right away and might slowly build up over time. Common symptoms for PV might include, but is not limited to: dizziness or vertigo, headaches, fatigue, vision problems such as double vision, blurred vision, and blind spots, excessive sweating, bleeding or bruising.
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Diagnosis
If a healthcare professional suspects someone PV, they will request a blood test or a CBC panel to look at the number of red and white blood cells in the body. If there is an excess of red and white blood cells, the provider will then a request a bone marrow aspiration and biopsy to see the health of the bone marrow and how much of the cells are being produced.
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Treatment
Presently, there is not a treatment for PV, instead, the goal is to control the symptoms and prevent any complications, if possible; most treatments focus on reducing the thickness of the blood. The treatments to help manage the symptoms include: frequent blood draws to reduce hematocrit, medications to minimize itching and medications to reduce the number of red blood cells. Some providers may even prescribe heart medication to reduce the risk of clots. Radiation treatment is also a treatment to repress overreactive bone marrow cells.
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Prevention
Primary polycythemia, unfortunately, cannot be prevented, but proper treatment can delay or prevent the onset of symptoms. Secondary polycythemia can be prevented by managing symptoms of major heart or lung diseases; avoiding activities or smoking, which limit how much oxygen the body receives can also prevent developing secondary polycythemia.