Polycythemia vera 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 increase as well..
This is a rare disorder that occurs more often in men than in women. It is not often 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.
Trouble breathing when lying down
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)
Other symptoms that may occur with this disease:
Bluish skin color
Red skin spots
Exams and Tests
The health care provider will perform a physical exam. You may also have the following tests:
Bone marrow biopsy
Complete blood count with differential
Comprehensive metabolic panel
Genetic test for the JAK2V617F mutation
Oxygen saturation of the blood
Red blood cell mass
Vitamin B12 level
This disease may also affect the results of the following tests:
Lactate dehydrogenase (LDH)
Leukocyte alkaline phosphatase
Platelet aggregation test
Serum uric acid
The goal of treatment is to reduce the thickness of the blood and prevent bleeding and clotting.
A method called phlebotomy is used to decrease blood thickness. One unit of blood (about 1 pint) is removed each week until the number of red blood cells drops. The treatment is continued as needed.
Other treatments may include:
Chemotherapy (specifically hydroxyurea) to reduce the number of red blood cells made by the bone marrow. This option may used when the numbers of other blood cell types are also high.
Interferon to lower blood counts.
Anagrelide to lower platelet counts
Taking aspirin to reduce the risk of blood clots may be an option for some people. However, aspirin increase the risk of stomach bleeding.
Ultraviolet-B light therapy can reduce the severe itching some patients experience.
Acute myelogenous leukemia (AML)
Bleeding from the stomach or other parts of the intestinal tract
Call your health care provider if symptoms of polycythemia vera develop.
Kremyanskaya M, Najfeld V, Mascarenhas J et al. The polycythemias. In: Hoffman R, Benz EJ Jr, Silberstein LE, Heslop HE, Weitz JI, eds. Hematology: Basic Principles and Practice. 6th ed. Philadelphia, PA: Saunders Elsevier; 2012:chap 67.