Polycythemia vera differential diagnosis: Difference between revisions
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||[[Polycythemia vera (PV)]] | ||[[Polycythemia vera (PV)]] | ||
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* JAK2 mutation (V617F or exon 12 mutation) in more than 95% of cases | * [[JAK2]] mutation (V617F or exon 12 mutation) in more than 95% of cases | ||
* Autonomous erythrocyte production | * Autonomous erythrocyte production | ||
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* Erythromelagia | * [[Erythromelagia]] | ||
* Headache | * [[Headache]] | ||
* Stroke-like symptoms | * [[Stroke]]-like symptoms | ||
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* Elevated [[hemoglobin]] | * Elevated [[hemoglobin]] | ||
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* [[Splenomegaly]] | * [[Splenomegaly]] | ||
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* Aspirin | * [[Aspirin]] | ||
* Ruxolitinib | * [[Ruxolitinib]] | ||
* Hydroxyurea | * [[Hydroxyurea]] | ||
* Phlebotomy | * [[Phlebotomy]] | ||
* Interferon-alpha | * [[Interferon-alpha]] | ||
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* [[Extramedullary hematopoiesis]] | * [[Extramedullary hematopoiesis]] | ||
* [[Stroke]] | * [[Stroke]] | ||
* [[Venous thrombosis]] | * [[Venous thrombosis]] | ||
* Can progress to post-PV myelofibrosis and eventually acute leukemia | * Can progress to post-PV [[myelofibrosis]] and eventually [[acute leukemia]] | ||
|- | |- | ||
||[[Essential thrombocythemia (ET) | ||[[Essential thrombocythemia]] (ET) | ||
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* Clonal proliferation of megakaryocytes | * Clonal proliferation of megakaryocytes | ||
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* Stroke-like symptoms | * Stroke-like symptoms | ||
* Fatigue | * [[Fatigue]] | ||
* Bleeding due to dysfunctional platelets and acquired von Willebrand disease | * Bleeding due to dysfunctional platelets and acquired [[von Willebrand disease]] | ||
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* Elevated total [[platelet]] count | * Elevated total [[platelet]] count | ||
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* Bruising | * Bruising | ||
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* Aspirin | * [[Aspirin]] | ||
* [[Hydroyurea]] | * [[Hydroyurea]] | ||
* [[Anagrelide]] | * [[Anagrelide]] | ||
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* Can develop into acute leukemia | * Can develop into acute leukemia | ||
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||[[Chronic myeloid leukemia (CML) | ||[[Chronic myeloid leukemia]] (CML) | ||
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* Reciprocal translocation of chromosomes 9 and 22 | * Reciprocal translocation of chromosomes 9 and 22 | ||
* Production of BCR-Abl kinase, which drives cell proliferation | * Production of BCR-Abl kinase, which drives cell proliferation | ||
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* Abdominal pain | * [[Abdominal pain]] | ||
* Infections | * [[Infection|Infections]] | ||
* Fever | * [[Fever]] | ||
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* Elevated total [[white blood cell count]] | * Elevated total [[white blood cell count]] | ||
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* Increased proportion of metamyelocytes and other [[white blood cells]] at various stages of maturation | * Increased proportion of metamyelocytes and other [[white blood cells]] at various stages of maturation | ||
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* Splenomegaly | * [[Splenomegaly]] | ||
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* Imatinib | * [[Imatinib]] | ||
* Dasatinib | * [[Dasatinib]] | ||
* Bosutinib | * [[Bosutinib]] | ||
* Nilotinib | * [[Nilotinib]] | ||
* Ponatinib for T315I kinase domain mutation | * [[Ponatinib]] for T315I kinase domain mutation | ||
* Interferon-alpha | * [[Interferon-alpha]] | ||
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* Can appear similar to leukemoid reaction | * Can appear similar to [[leukemoid reaction]] | ||
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|[[Primary myelofibrosis (PMF) | |[[Primary myelofibrosis]] (PMF) | ||
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* Clonal disorder of megakaryocytes | * Clonal disorder of megakaryocytes | ||
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* [[Ruxolitinib]] | * [[Ruxolitinib]] | ||
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* Variable risk for development of acute leukemia | * Variable risk for development of [[acute leukemia]] | ||
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|| | ||Secondary polycythemia | ||
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* [[Congestive heart failure]] (CHF) | * [[Congestive heart failure]] (CHF) | ||
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* Smoking | * Smoking | ||
* High altitude living | * High altitude living | ||
* Ectopic erythropoietin production from tumor (renal cell carcinoma or hepatocellular carcinoma) | * Ectopic [[erythropoietin]] production from tumor (renal cell carcinoma or hepatocellular carcinoma) | ||
* Chronic hypoxia from a variety of other causes | * Chronic [[hypoxia]] from a variety of other causes | ||
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* Headache | * [[Headache]] | ||
* Fatigue | * [[Fatigue]] | ||
* Shortness of breath | * [[Shortness of breath]] | ||
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* Elevated [[hemoglobin]] | * Elevated [[hemoglobin]] | ||
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* [[Crackles]] | * [[Crackles]] | ||
* Cyanosis | * [[Cyanosis]] | ||
* Tachypnea | * [[Tachypnea]] | ||
* Tachycardia | * [[Tachycardia]] | ||
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* Treatment of underlying cause of hypoxia | * Treatment of underlying cause of hypoxia | ||
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* Steroids for ILD | * Steroids for ILD | ||
* Continuous positive airway pressure for OSA | * Continuous positive airway pressure for OSA | ||
* Smoking cessation or nicotine replacement | * [[Smoking cessation]] or nicotine replacement | ||
* Surgical removal of tumors | * Surgical removal of tumors | ||
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:<ref name="pmid25611051">{{cite journal| author=Tefferi A, Barbui T| title=Polycythemia vera and essential thrombocythemia: 2015 update on diagnosis, risk-stratification and management. | journal=Am J Hematol | year= 2015 | volume= 90 | issue= 2 | pages= 162-73 | pmid=25611051 | doi=10.1002/ajh.23895 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25611051 }} </ref><ref name="pmid16879015">{{cite journal| author=Sanchez S, Ewton A| title=Essential thrombocythemia: a review of diagnostic and pathologic features. | journal=Arch Pathol Lab Med | year= 2006 | volume= 130 | issue= 8 | pages= 1144-50 | pmid=16879015 | doi=10.1043/1543-2165(2006)130[1144:ET]2.0.CO;2 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16879015 }} </ref><ref name="pmid24729196">{{cite journal| author=Jabbour E, Kantarjian H| title=Chronic myeloid leukemia: 2014 update on diagnosis, monitoring, and management. | journal=Am J Hematol | year= 2014 | volume= 89 | issue= 5 | pages= 547-56 | pmid=24729196 | doi=10.1002/ajh.23691 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24729196 }} </ref> | :<ref name="pmid25611051">{{cite journal| author=Tefferi A, Barbui T| title=Polycythemia vera and essential thrombocythemia: 2015 update on diagnosis, risk-stratification and management. | journal=Am J Hematol | year= 2015 | volume= 90 | issue= 2 | pages= 162-73 | pmid=25611051 | doi=10.1002/ajh.23895 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25611051 }} </ref><ref name="pmid16879015">{{cite journal| author=Sanchez S, Ewton A| title=Essential thrombocythemia: a review of diagnostic and pathologic features. | journal=Arch Pathol Lab Med | year= 2006 | volume= 130 | issue= 8 | pages= 1144-50 | pmid=16879015 | doi=10.1043/1543-2165(2006)130[1144:ET]2.0.CO;2 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16879015 }} </ref><ref name="pmid24729196">{{cite journal| author=Jabbour E, Kantarjian H| title=Chronic myeloid leukemia: 2014 update on diagnosis, monitoring, and management. | journal=Am J Hematol | year= 2014 | volume= 89 | issue= 5 | pages= 547-56 | pmid=24729196 | doi=10.1002/ajh.23691 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24729196 }} </ref> | ||
Revision as of 14:06, 21 February 2018
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Polycythemia vera Microchapters |
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Polycythemia vera differential diagnosis On the Web |
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American Roentgen Ray Society Images of Polycythemia vera differential diagnosis |
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Risk calculators and risk factors for Polycythemia vera differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Mohamad Alkateb, MBBCh [2] Shyam Patel [3]
Overview
Polycythemia vera must be differentiated from other myeloproliferative neoplasms, such as chronic myelogenous leukemia, essential thrombocythemia, and primary myelofibrosis. Polycythemia vera must also be differentiated from secondary polycythemia, which is usually due to chronic hypoxia. Each of these conditions have different etiologies, symptoms, laboratory abnormalities, physical exam findings, and treatments.
Differential Diagnosis
Polycythemia vera must be differentiated from a variety of other conditions.
| Characteristic/Parameter | Etiology | Symptoms | Laboratory abnormalities | Physical examination | Treatment | Other associated abnormalities |
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| Polycythemia vera (PV) |
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| Essential thrombocythemia (ET) |
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| Chronic myeloid leukemia (CML) |
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| Primary myelofibrosis (PMF) |
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| Secondary polycythemia |
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References
- ↑ Tefferi A, Barbui T (2015). "Polycythemia vera and essential thrombocythemia: 2015 update on diagnosis, risk-stratification and management". Am J Hematol. 90 (2): 162–73. doi:10.1002/ajh.23895. PMID 25611051.
- ↑ Sanchez S, Ewton A (2006). "Essential thrombocythemia: a review of diagnostic and pathologic features". Arch Pathol Lab Med. 130 (8): 1144–50. doi:10.1043/1543-2165(2006)130[1144:ET]2.0.CO;2. PMID 16879015.
- ↑ Jabbour E, Kantarjian H (2014). "Chronic myeloid leukemia: 2014 update on diagnosis, monitoring, and management". Am J Hematol. 89 (5): 547–56. doi:10.1002/ajh.23691. PMID 24729196.