Friday, December 2, 2011

Blood Disorders: Polycythemia Vera

Polycythemia vera is not a cancer,but is a disease of the bone marrow.  Hematology oncologists handle the diagnosis and treatment of this disease. The bone marrow makes too many red cells.  Polycythemia is rare and develops slowly.  The problem of elevated red blood cells is usually found in a routine complete blood count which is ordered by doctor.   The image below shows what polycythemia vera looks like under the microscope.

If  polycythemia vera is not treated then it could become life threatening. The symptoms are the following:
In its early stages, polycythemia vera usually doesn't cause any signs or symptoms. However, as the disease progresses, you may experience:
  • Headache
  • Dizziness
  • Itchiness, especially following a warm bath or shower
  • Redness of your skin
  • Shortness of breath
  • Breathing difficulty when you lie down
  • Numbness, tingling, burning or weakness in your hands, feet, arms or legs
  • A feeling of fullness or bloating in your left upper abdomen due to an enlarged spleen
  • Fatigue  
Blood tests
Doctors most frequently use blood tests to diagnose polycythemia vera. If you have polycythemia vera, blood tests may reveal:
  • An increase in the number of red blood cells and, in some cases, an increase in platelets or white blood cells.
  • Elevated hematocrit measurement, the percentage of red blood cells that make up total blood volume.
  • Elevated levels of hemoglobin, the iron-rich protein in red blood cells that carries oxygen.
  • Very low levels of erythropoietin (EPO), a hormone that stimulates bone marrow to produce new red blood cells.
Bone marrow aspiration or biopsy
If your doctor suspects you have polycythemia vera, he or she may recommend a bone marrow aspiration or biopsy to collect a sample of your bone marrow. A bone marrow biopsy involves taking a sample of solid bone marrow material. A bone marrow aspiration is usually done at the same time as a biopsy. During an aspiration, your doctor withdraws a sample of the liquid portion of your marrow.
If an examination of your bone marrow shows that it's producing higher than normal numbers of blood cells, it may be a sign of polycythemia vera.
Tests for the gene mutation that causes polycythemia vera
If you have polycythemia vera, analysis of your bone marrow or blood also may show the mutation in the cells (JAK2 V617F mutation) that's associated with the disease.
n a bone marrow aspiration and biopsy, a doctor or nurse uses a thin needle to remove a small amount of liquid bone marrow, usually from a spot in the back of your hipbone called the posterior iliac crest. A bone marrow biopsy is often taken at the same time. This second procedure removes a small piece of bone tissue and the enclosed marrow.

Treatment of polycythemia include doing a phlebotomy to remove blood that is putting your circulatory system in overload.  It is similar to giving blood to the Red Cross.  Drugs are given if the phlebotomy is not enough to relieve the increased red cell production.  
 Hydroxyurea (Droxia, Hydrea) or anagrelide (Agrylin), to suppress your bone marrow's ability to produce blood cells may be used. Interferon-alpha may be used to stimulate your immune system to fight the overproduction of red blood cells.
Any abnormal symptoms should always be addressed by a doctor.  Be in tune with your body and document changes to help the doctor to have a clearer picture of your health problems.

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1 comment:

  1. Two main invasive interventions are done for Polycythemia Vera Treatment first phlebotomy and second bloodletting. But these both procedures are invasive. The best herbal medication today available in market for the management of this disease is Veraceton herbal product by Herbs Solutions By Nature. It is a product made up of 100% natural herbs so is free from any unwanted side effects.