Polycythemia vera laboratory tests: Difference between revisions
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==Laboratory Findings== | ==Laboratory Findings== | ||
Laboratory findings associated with polycythemia vera include:<ref name="cancer.ca">Canadian Cancer Society.2015.http://www.cancer.ca/en/cancer-information/cancer-type/leukemia/leukemia/polycythemia-vera/?region=ab</ref><ref name="pmid26534968">{{cite journal| author=Hawley JM, Owen LJ, MacKenzie F, Mussell C, Cowen S, Keevil BG| title=Candidate Reference Measurement Procedure for the Quantification of Total Serum Cortisol with LC-MS/MS. | journal=Clin Chem | year= 2015 | volume= | issue= | pages= | pmid=26534968 | doi=10.1373/clinchem.2015.243576 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26534968 }} </ref><ref name="pmid7889510">{{cite journal| author=Amiel A, Gaber E, Manor Y, Fejgin M, Joseph-Lerner N, Ravid M et al.| title=Fluorescence in situ hybridization for the detection of trisomies 8 and 9 in polycythemia vera. | journal=Cancer Genet Cytogenet | year= 1995 | volume= 79 | issue= 2 | pages= 153-6 | pmid=7889510 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7889510 }} </ref><ref name="pmid17178662">{{cite journal| author=Mazzotta S, Guerranti R, Gozzetti A, Bucalossi A, Bocchia M, Sammassimo S et al.| title=Increased serum lactate dehydrogenase isoenzymes in Ph-negative chronic myeloproliferative diseases: a metabolic adaptation? | journal=Hematology | year= 2006 | volume= 11 | issue= 4 | pages= 239-44 | pmid=17178662 | doi=10.1080/10245330600774835 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17178662 }} </ref><ref name="pmid5947579">{{cite journal| author=Denman M, Szur L, Ansell BM| title=Hyperuricaemia in polycythaemia vera. | journal=Ann Rheum Dis | year= 1966 | volume= 25 | issue= 4 | pages= 340-4 | pmid=5947579 | doi= | pmc=PMC2453349 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=5947579 }} </ref><ref name="pmid23606974">{{cite journal| author=Murakami J, Shimizu Y| title=Hepatic manifestations in hematological disorders. | journal=Int J Hepatol | year= 2013 | volume= 2013 | issue= | pages= 484903 | pmid=23606974 | doi=10.1155/2013/484903 | pmc=PMC3626309 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23606974 }} </ref><ref name="pmid9299851">{{cite journal| author=Remacha AF, Montserrat I, Santamaria A, Oliver A, Barceló MJ, Parellada M| title=Serum erythropoietin in the diagnosis of polycythemia vera. A follow-up study. | journal=Haematologica | year= 1997 | volume= 82 | issue= 4 | pages= 406-10 | pmid=9299851 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9299851 }} </ref><ref name="pmid26324368">{{cite journal |vauthors=Stein BL, Oh ST, Berenzon D, Hobbs GS, Kremyanskaya M, Rampal RK, Abboud CN, Adler K, Heaney ML, Jabbour EJ, Komrokji RS, Moliterno AR, Ritchie EK, Rice L, Mascarenhas J, Hoffman R |title=Polycythemia Vera: An Appraisal of the Biology and Management 10 Years After the Discovery of JAK2 V617F |journal=J. Clin. Oncol. |volume=33 |issue=33 |pages=3953–60 |date=November 2015 |pmid=26324368 |pmc=4979103 |doi=10.1200/JCO.2015.61.6474 |url=}}</ref> | Laboratory findings associated with polycythemia vera include:<ref name="cancer.ca">Canadian Cancer Society.2015.http://www.cancer.ca/en/cancer-information/cancer-type/leukemia/leukemia/polycythemia-vera/?region=ab</ref><ref name="pmid26534968">{{cite journal| author=Hawley JM, Owen LJ, MacKenzie F, Mussell C, Cowen S, Keevil BG| title=Candidate Reference Measurement Procedure for the Quantification of Total Serum Cortisol with LC-MS/MS. | journal=Clin Chem | year= 2015 | volume= | issue= | pages= | pmid=26534968 | doi=10.1373/clinchem.2015.243576 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26534968 }} </ref><ref name="pmid7889510">{{cite journal| author=Amiel A, Gaber E, Manor Y, Fejgin M, Joseph-Lerner N, Ravid M et al.| title=Fluorescence in situ hybridization for the detection of trisomies 8 and 9 in polycythemia vera. | journal=Cancer Genet Cytogenet | year= 1995 | volume= 79 | issue= 2 | pages= 153-6 | pmid=7889510 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7889510 }} </ref><ref name="pmid17178662">{{cite journal| author=Mazzotta S, Guerranti R, Gozzetti A, Bucalossi A, Bocchia M, Sammassimo S et al.| title=Increased serum lactate dehydrogenase isoenzymes in Ph-negative chronic myeloproliferative diseases: a metabolic adaptation? | journal=Hematology | year= 2006 | volume= 11 | issue= 4 | pages= 239-44 | pmid=17178662 | doi=10.1080/10245330600774835 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17178662 }} </ref><ref name="pmid5947579">{{cite journal| author=Denman M, Szur L, Ansell BM| title=Hyperuricaemia in polycythaemia vera. | journal=Ann Rheum Dis | year= 1966 | volume= 25 | issue= 4 | pages= 340-4 | pmid=5947579 | doi= | pmc=PMC2453349 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=5947579 }} </ref><ref name="pmid23606974">{{cite journal| author=Murakami J, Shimizu Y| title=Hepatic manifestations in hematological disorders. | journal=Int J Hepatol | year= 2013 | volume= 2013 | issue= | pages= 484903 | pmid=23606974 | doi=10.1155/2013/484903 | pmc=PMC3626309 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23606974 }} </ref><ref name="pmid9299851">{{cite journal| author=Remacha AF, Montserrat I, Santamaria A, Oliver A, Barceló MJ, Parellada M| title=Serum erythropoietin in the diagnosis of polycythemia vera. A follow-up study. | journal=Haematologica | year= 1997 | volume= 82 | issue= 4 | pages= 406-10 | pmid=9299851 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9299851 }} </ref><ref name="pmid26324368">{{cite journal |vauthors=Stein BL, Oh ST, Berenzon D, Hobbs GS, Kremyanskaya M, Rampal RK, Abboud CN, Adler K, Heaney ML, Jabbour EJ, Komrokji RS, Moliterno AR, Ritchie EK, Rice L, Mascarenhas J, Hoffman R |title=Polycythemia Vera: An Appraisal of the Biology and Management 10 Years After the Discovery of JAK2 V617F |journal=J. Clin. Oncol. |volume=33 |issue=33 |pages=3953–60 |date=November 2015 |pmid=26324368 |pmc=4979103 |doi=10.1200/JCO.2015.61.6474 |url=}}</ref><ref name="pmid27069254">{{cite journal| author=Arber DA, Orazi A, Hasserjian R, Thiele J, Borowitz MJ, Le Beau MM et al.| title=The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. | journal=Blood | year= 2016 | volume= 127 | issue= 20 | pages= 2391-405 | pmid=27069254 | doi=10.1182/blood-2016-03-643544 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27069254 }} </ref> | ||
*[[Complete blood count]] | *[[Complete blood count]] | ||
:*[[Erythrocytosis]]: This is a hallmark laboratory finding in polycythemia vera. | :*[[Erythrocytosis]]: This is a hallmark laboratory finding in polycythemia vera. | ||
| Line 30: | Line 30: | ||
*[[Erythropoietin]] (EPO) | *[[Erythropoietin]] (EPO) | ||
:*It is usually low in polycythemia vera but can be normal in about 20% of patients. | :*It is usually low in polycythemia vera but can be normal in about 20% of patients. | ||
:*It is usually high in secondary polycythemia vera. | :*It is usually high in secondary polycythemia vera. | ||
*[[Bone marrow biopsy]] | *[[Bone marrow biopsy]] | ||
:*Elevation of [[white blood cells]], [[red blood cells]], and [[platelets]] | :*Elevation of [[white blood cells]], [[red blood cells]], and [[platelets]] | ||
Revision as of 16:54, 22 January 2019
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohamad Alkateb, MBBCh [2]; Shyam Patel [3]
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Overview
Laboratory findings associated with the diagnosis of polycythemia vera include erythrocytosis, leukocytosis, and thrombocytosis. The most sensitive test for polycythemia vera is JAK2 V617F mutation testing in the peripheral blood. A specific finding in patients with polycythemia vera is low erythropoietin level.
Laboratory Findings
Laboratory findings associated with polycythemia vera include:[1][2][3][4][5][6][7][8][9]
- Erythrocytosis: This is a hallmark laboratory finding in polycythemia vera.
- Increased hemoglobin: Hemoglobin is usually more than 16.5 g/dl in women and more than 18.5 g/dl in men. Elevated hemoglobin corresponds with elevated red blood cell mass.
- Increased granulocytes of all types: Polycythemia vera is characterized by panmyelosis (elevation of cell counts of all 3 cell lines).
- Increased basophils and eosinophils
- Thrombocytosis
- Leukocytosis
- The following blood levels may be elevated (but these are non-specific)
- Blood urea nitrogen (BUN)
- Creatinine
- Phosphate
- Lactate dehydrogenase (LDH)
- Alanine aminotransferase (ALT)
- Aspartate transaminase (AST)
- Uric acid
- Peripheral blood mutational testing
- Bleeding and clotting factor
- Erythropoietin (EPO)
- It is usually low in polycythemia vera but can be normal in about 20% of patients.
- It is usually high in secondary polycythemia vera.
- Elevation of white blood cells, red blood cells, and platelets
References
- ↑ Canadian Cancer Society.2015.http://www.cancer.ca/en/cancer-information/cancer-type/leukemia/leukemia/polycythemia-vera/?region=ab
- ↑ Hawley JM, Owen LJ, MacKenzie F, Mussell C, Cowen S, Keevil BG (2015). "Candidate Reference Measurement Procedure for the Quantification of Total Serum Cortisol with LC-MS/MS". Clin Chem. doi:10.1373/clinchem.2015.243576. PMID 26534968.
- ↑ Amiel A, Gaber E, Manor Y, Fejgin M, Joseph-Lerner N, Ravid M; et al. (1995). "Fluorescence in situ hybridization for the detection of trisomies 8 and 9 in polycythemia vera". Cancer Genet Cytogenet. 79 (2): 153–6. PMID 7889510.
- ↑ Mazzotta S, Guerranti R, Gozzetti A, Bucalossi A, Bocchia M, Sammassimo S; et al. (2006). "Increased serum lactate dehydrogenase isoenzymes in Ph-negative chronic myeloproliferative diseases: a metabolic adaptation?". Hematology. 11 (4): 239–44. doi:10.1080/10245330600774835. PMID 17178662.
- ↑ Denman M, Szur L, Ansell BM (1966). "Hyperuricaemia in polycythaemia vera". Ann Rheum Dis. 25 (4): 340–4. PMC 2453349. PMID 5947579.
- ↑ Murakami J, Shimizu Y (2013). "Hepatic manifestations in hematological disorders". Int J Hepatol. 2013: 484903. doi:10.1155/2013/484903. PMC 3626309. PMID 23606974.
- ↑ Remacha AF, Montserrat I, Santamaria A, Oliver A, Barceló MJ, Parellada M (1997). "Serum erythropoietin in the diagnosis of polycythemia vera. A follow-up study". Haematologica. 82 (4): 406–10. PMID 9299851.
- ↑ Stein BL, Oh ST, Berenzon D, Hobbs GS, Kremyanskaya M, Rampal RK, Abboud CN, Adler K, Heaney ML, Jabbour EJ, Komrokji RS, Moliterno AR, Ritchie EK, Rice L, Mascarenhas J, Hoffman R (November 2015). "Polycythemia Vera: An Appraisal of the Biology and Management 10 Years After the Discovery of JAK2 V617F". J. Clin. Oncol. 33 (33): 3953–60. doi:10.1200/JCO.2015.61.6474. PMC 4979103. PMID 26324368.
- ↑ Arber DA, Orazi A, Hasserjian R, Thiele J, Borowitz MJ, Le Beau MM; et al. (2016). "The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia". Blood. 127 (20): 2391–405. doi:10.1182/blood-2016-03-643544. PMID 27069254.