Polycythemia vera laboratory tests: Difference between revisions
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{{CMG}}{{AE}}{{MJK}} | {{CMG}}{{AE}}{{MJK}} {{shyam}} | ||
{{Polycythemia vera}} | {{Polycythemia vera}} | ||
==Overview== | ==Overview== | ||
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:*Increased [[granulocyte]]s of all types: Polycythemia vera is characterized by panmyelosis (elevation of cell counts of all 3 cell lines). | :*Increased [[granulocyte]]s of all types: Polycythemia vera is characterized by panmyelosis (elevation of cell counts of all 3 cell lines). | ||
:*Increased [[basophil]]s and [[eosinophil]]s | :*Increased [[basophil]]s and [[eosinophil]]s | ||
:*[[Thrombocytosis]] | :*[[Thrombocytosis]]: This is an elevation of platelet count to more than 400,000/mcl. | ||
:*[[Leukocytosis]] | :*[[Leukocytosis]]: This is an elevation of white blood cell count to more than 11,000/mcl. | ||
*Blood chemistry | *Blood chemistry | ||
:*The following blood levels may be elevated (but these are non-specific): | :*The following blood levels may be elevated (but these are non-specific): | ||
| Line 26: | Line 26: | ||
::*[[Prothrombin time]] (PT) or [[international normalized ratio]] (INR) | ::*[[Prothrombin time]] (PT) or [[international normalized ratio]] (INR) | ||
::*[[Partial thromboplastin time]] (PTT) | ::*[[Partial thromboplastin time]] (PTT) | ||
*[[ | *[[Flow cytometry]]: Flow cytometry of the peripheral blood is usually normal in polycythemia vera. There is usually no abnormal immunophenotype. | ||
*[[Cytogenetics]]: Cytogenetics are usually normal in patients with polycythemia vera. | |||
*[[Cytogenetics]] | *[[Fluorescent in situ hybridization]] (FISH): FISH is usually normal in polycythemia vera. There are no particular translocations, deletions, insertions, or duplications. | ||
*[[Fluorescent in situ hybridization]] (FISH) | *[[Erythropoietin]] (EPO): Erythropoietin is usually low in polycythemia vera. Low erythropoietin is a minor diagnostic criteria for polycythemia vera in the 2016 WHO classification of myeloproliferative neoplasms. In contrast, erythropoietin is usually high in secondary polycythemia.<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> | ||
*[[Erythropoietin]] (EPO) | |||
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: | |||
==References== | ==References== | ||
Revision as of 05:47, 18 February 2018
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.[1]
Laboratory Findings
Laboratory findings associated with polycythemia vera include:[1][2][3][4][5][6][7]
- Erythrocytosis: This is a hallmark laboratory finding in polycythemia vera.
- Increased hemoglobin: Hemoglobin is usually more than 16.5 g/dl. 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: This is an elevation of platelet count to more than 400,000/mcl.
- Leukocytosis: This is an elevation of white blood cell count to more than 11,000/mcl.
- Blood chemistry
- 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
- Bleeding and clotting factor
- The following blood levels may be elevated:
- Prothrombin time (PT) or international normalized ratio (INR)
- Partial thromboplastin time (PTT)
- Flow cytometry: Flow cytometry of the peripheral blood is usually normal in polycythemia vera. There is usually no abnormal immunophenotype.
- Cytogenetics: Cytogenetics are usually normal in patients with polycythemia vera.
- Fluorescent in situ hybridization (FISH): FISH is usually normal in polycythemia vera. There are no particular translocations, deletions, insertions, or duplications.
- Erythropoietin (EPO): Erythropoietin is usually low in polycythemia vera. Low erythropoietin is a minor diagnostic criteria for polycythemia vera in the 2016 WHO classification of myeloproliferative neoplasms. In contrast, erythropoietin is usually high in secondary polycythemia.[8]
References
- ↑ 1.0 1.1 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.
- ↑ 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.