Polycythemia differential diagnosis: Difference between revisions

	Polycythemia Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Polycythemia from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Study of Choice
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X-ray
Echocardiography or Ultrasound
CT scan
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Interventions
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Polycythemia differential diagnosis On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Polycythemia differential diagnosis All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Polycythemia differential diagnosis
CDC on Polycythemia differential diagnosis
Polycythemia differential diagnosis in the news
Blogs on Polycythemia differential diagnosis
Directions to Hospitals Treating Polycythemia
Risk calculators and risk factors for Polycythemia differential diagnosis

← Older edit Newer edit →

VisualWikitext

Revision as of 14:01, 24 August 2018

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]

Overview

Polycythemia manifests in a variety of clinical forms, differentiation must be established in accordance with the particular subtype. Primary and secondary polycythemia must be differentiated from each other. Primary polycythemia might be seen in patients with various mutations. Iatrogenic causes including medications, athletic drugs, and smoking might cause primary polycythemia. Secondary polycythemia must be differentiated in patients with chronic hypoxemia, erythropoietin producing tumors, or arteriovenous malformations.

Differential Diagnosis of Polycythemia

Polycythemia must be differentiated from a variety of other conditions.^[1]^[2]^[3]

Category	Disease	Etiology	Mutation	Clinical manifestations														Laboratory findings						Gold standard disgnosis	Associated findings
				Demography	Symptoms						Signs							CBC				EPO level	PBS
				Demography	Fatigue	Headache	Shortness of breath	Bleeding	Pain	Other symptoms	Appearance	SaO2	Fever	BP	Tenderness	Splenomegaly	Other signs	Hb	RBC	WBC	Plt	EPO level	PBS
Mutational causes	Polycythemia vera (PV)^[4]	Autonomous erythrocyte production	JAK2 mutation (> 95%)	Mean age >60 years old	+	+	+	±	Erythromelagia Chest pain	Stroke-like symptoms Pruritis Dizziness Visual disturbance	Facial plethora	Nl	−	↑	Painful erythema	+	Lymphadenopathy	↑	↑ RBC mass	Nl to ↑	Nl to ↑	↓	Elevated normochromic, normocytic RBCs Thrombocytosis Rarely immature cells Leukoerythroblastic picture	WHO criteria for PV	Stroke Venous thrombosis Myelofibrosis Acute leukemia
	Chuvash polycythemia^[5]	Hypoxia-sensing disorder	VHL mutation	Russia, Italy <40 years old	+	+	+	±	Arthralgia	Pruritis Dizziness	Facial plethora	↓	−	↑	Painful erythema	+	Lymphadenopathy	↑	↑	Nl	Nl	↑	Elevated normochromic, normocytic RBCs	Molecular genetic testing	Multiple thrombotic events
	Hereditary methemoglobinemia^[6]	Cytochrome b5 reductase deficiency Hemoglobin M disease	Mutations in globin gene	Infants	±	±	±	−	−	−	Cyanosis	Inaccurately Nl	−	Nl	−	−	Altered mental status	↑	↑	Nl	Nl	Nl	NA	RBC enzyme activity + DNA analysis	Usually asymptomatic
	Primary familial and congenital polycythemia^[7]	Autosomal dominant inheritance	EPOR mutation	Very rare	+	+	±	−	−	−	Facial plethora	Nl	−	Nl to ↑	−	−	Altered mental status	↑	↑	Nl	Nl	Nl to ↓	NA	Isolated erythrocytosis + genetic testing	Mild manifestations of hyperviscosity
Category	Disease	Etiology	Mutation	Demography	Fatigue	Headache	Shortness of breath	Bleeding	Pain	Other symptoms	Appearance	SaO2	Fever	BP	Tenderness	Splenomegaly	Other signs	Hb	RBC	WBC	Plt	EPO level	PBS	Gold standard diagnosis	Associated findings
Iatrogenic causes	Smoking^[8]^[9]	Reduced plasma volume Accelerated erythropoiesis	−	Any	−	−	+	−	−	−	Cyanosis	↓	−	Nl	−	−	−	↑	Nl	Nl to ↑	Nl to ↑	Nl to ↓	NA	Clinical manifestation	NA
	Chronic exposure to carbon monoxide^[10]	Occupational exposure	−	Miners, fire fighters	+	+	+	−	−	Dizziness Altered cognition	Cyanosis, flushed cheeks	Nl	−	Nl	−	−	−	↑	↑	Nl	Nl	Nl to ↓	NA	Blood level of carboxyhemoglobin	Concomitant cyanide exposure
	Diuretics^[11]	Reduced plasma volume	−	Any	−	−	−	−	−	Dizziness	Nl	Nl	−	Nl to ↓	−	−	−	↑	Nl	Nl	Nl	Nl to ↓	NA	Clinical manifestation	NA
	Use of androgens or anabolic steroids^[12]^[13]	Reduced plasma volume Accelerated erythropoiesis	−	Athletes	−	+	+	−	−	−	Acne and hirsutism	Nl	−	Nl to ↑	−	−	Gynecomastia	↑	↑	Nl	Nl	↓	NA	Clinical manifestation	Hypogonadism Cardiac hypertrophy
	Self−injection of erythropoietin^[14]	Reduced plasma volume Accelerated erythropoiesis	−	Athletes	−	+	+	−	−	−	Muscular	↓	−	↑	−	−	−	↑	↑	Nl	Nl	↑	NA	Erythropoietin level	MI Stroke Thromboembolic disease Antibody-mediated anemia
Secondary causes	Secondary polycythemia due to hypoxemia^[15]	Chronic lung disease Right-to-left cardiac shunts Sleep apnea High altitude	−	Depends on etiology	+	+	+	−	Depends on etiology	Shortness of breath	Cyanosis	↓	−	Nl to ↑	−	−	Crackles Tachypnea Tachycardia	↑	↑	Nl	Nl	↑	NA	Clinical manifestation + imaging	Variable manifestations given the diverse etiologies
	Secondary polycythemia due to erythropoietin producing tumor^[16]	Renal cell carcinoma Hepatocellular carcinoma Cerebellar hemangioblastoma Pheochromocytoma Uterine fibroids	−	Depends on etiology	+	−	−	−	Depends on etiology	Depends on etiology	Chronically ill	Nl	±	Nl to ↑	±	±	Hepatomegaly Bruising	↑/↓	↑/↓	Nl	↑	↑	NA	Clinical manifestation + biopsy	Variable manifestations given the diverse etiologies
	Hereditary hemorrhagic telangiectasia^[17]	Pulmonary arteriovenous malformations	ACVRL1, ENG, GDF2, SMAD4 mutation	Children	−	+	+	GI bleeding	−	Epistaxis Hemoptysis	Multiple telangiectasia on face, extremities, and body	Nl to ↓	−	Nl	−	−	−	↑/↓	↑/↓	Nl	Nl	↑/↓	NA	Clinical criteria + genomic testing	Autosomal dominant Pulmonary hypertension Cerebral AVMs
Category	Disease	Etiology	Mutation	Demography	Fatigue	Headache	Shortness of breath	Bleeding	Pain	Other symptoms	Appearance	SaO2	Fever	BP	Tenderness	Splenomegaly	Other signs	Hb	RBC	WBC	Plt	EPO level	PBS	Gold standard diagnosis	Associated findings

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.
↑ Stein, Brady L.; Oh, Stephen T.; Berenzon, Dmitriy; Hobbs, Gabriela S.; Kremyanskaya, Marina; Rampal, Raajit K.; Abboud, Camille N.; Adler, Kenneth; Heaney, Mark L.; Jabbour, Elias J.; Komrokji, Rami S.; Moliterno, Alison R.; Ritchie, Ellen K.; Rice, Lawrence; Mascarenhas, John; Hoffman, Ronald (2015). "Polycythemia Vera: An Appraisal of the Biology and Management 10 Years After the Discovery ofJAK2 V617F". Journal of Clinical Oncology. 33 (33): 3953–3960. doi:10.1200/JCO.2015.61.6474. ISSN 0732-183X.
↑ Zhou, Amy W.; Knoche, Eric M.; Engle, Elizabeth K.; Ban-Hoefen, Makiko; Kaiwar, Charu; Oh, Stephen T. (2016). "Clinical Improvement with JAK2 Inhibition in Chuvash Polycythemia". New England Journal of Medicine. 375 (5): 494–496. doi:10.1056/NEJMc1600337. ISSN 0028-4793.
↑ Da-Silva SS, Sajan IS, Underwood JP (August 2003). "Congenital methemoglobinemia: a rare cause of cyanosis in the newborn--a case report". Pediatrics. 112 (2): e158–61. PMID 12897322.
↑ Bento C, McMullin MF, Percy M, et al. Primary Familial and Congenital Polycythemia. 2016 Nov 10. In: Adam MP, Ardinger HH, Pagon RA, et al., editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2018. Available from: https://www.ncbi.nlm.nih.gov/books/NBK395975/
↑ Hasselbalch, Hans Carl (2015). "Smoking as a contributing factor for development of polycythemia vera and related neoplasms". Leukemia Research. 39 (11): 1137–1145. doi:10.1016/j.leukres.2015.09.002. ISSN 0145-2126.
↑ Malenica, Maja; Prnjavorac, Besim; Bego, Tamer; Dujic, Tanja; Semiz, Sabina; Skrbo, Selma; Gusic, Amar; Hadzic, Ajla; Causevic, Adlija (2017). "Effect of Cigarette Smoking on Haematological Parameters in Healthy Population". Medical Archives. 71 (2): 132. doi:10.5455/medarh.2017.71.132-136. ISSN 0350-199X.
↑ Wu, P. E.; Juurlink, D. N. (2014). "Carbon monoxide poisoning". Canadian Medical Association Journal. 186 (8): 611–611. doi:10.1503/cmaj.130972. ISSN 0820-3946.
↑ Pollak R, Maddux MS, Cohan J, Jacobsson PK, Mozes MF (March 1988). "Erythrocythemia following renal transplantation: influence of diuretic therapy". Clin. Nephrol. 29 (3): 119–23. PMID 3282731.
↑ Krauss DJ, Taub HA, Lantinga LJ, Dunsky MH, Kelly CM (December 1991). "Risks of blood volume changes in hypogonadal men treated with testosterone enanthate for erectile impotence". J. Urol. 146 (6): 1566–70. PMID 1942342.
↑ Morales A, Johnston B, Heaton JP, Lundie M (March 1997). "Testosterone supplementation for hypogonadal impotence: assessment of biochemical measures and therapeutic outcomes". J. Urol. 157 (3): 849–54. PMID 9072584.
↑ Elliott, S (2008). "Erythropoiesis-stimulating agents and other methods to enhance oxygen transport". British Journal of Pharmacology. 154 (3): 529–541. doi:10.1038/bjp.2008.89. ISSN 0007-1188.
↑ Nadeem, Omar; Gui, Jiang; Ornstein, Deborah L. (2012). "Prevalence of Venous Thromboembolism in Patients With Secondary Polycythemia". Clinical and Applied Thrombosis/Hemostasis. 19 (4): 363–366. doi:10.1177/1076029612460425. ISSN 1076-0296.
↑ Da Silva JL, Lacombe C, Bruneval P, Casadevall N, Leporrier M, Camilleri JP, Bariety J, Tambourin P, Varet B (February 1990). "Tumor cells are the site of erythropoietin synthesis in human renal cancers associated with polycythemia". Blood. 75 (3): 577–82. PMID 2297568.
↑ McDonald J, Pyeritz RE. Hereditary Hemorrhagic Telangiectasia. 2000 Jun 26 [Updated 2017 Feb 2]. In: Adam MP, Ardinger HH, Pagon RA, et al., editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2018. Available from: https://www.ncbi.nlm.nih.gov/books/NBK1351/

[pmid25611051-1] 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.

[pmid16879015-2] 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.

[pmid24729196-3] 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.

[SteinOh2015-4] Stein, Brady L.; Oh, Stephen T.; Berenzon, Dmitriy; Hobbs, Gabriela S.; Kremyanskaya, Marina; Rampal, Raajit K.; Abboud, Camille N.; Adler, Kenneth; Heaney, Mark L.; Jabbour, Elias J.; Komrokji, Rami S.; Moliterno, Alison R.; Ritchie, Ellen K.; Rice, Lawrence; Mascarenhas, John; Hoffman, Ronald (2015). "Polycythemia Vera: An Appraisal of the Biology and Management 10 Years After the Discovery ofJAK2 V617F". Journal of Clinical Oncology. 33 (33): 3953–3960. doi:10.1200/JCO.2015.61.6474. ISSN 0732-183X.

[ZhouKnoche2016-5] Zhou, Amy W.; Knoche, Eric M.; Engle, Elizabeth K.; Ban-Hoefen, Makiko; Kaiwar, Charu; Oh, Stephen T. (2016). "Clinical Improvement with JAK2 Inhibition in Chuvash Polycythemia". New England Journal of Medicine. 375 (5): 494–496. doi:10.1056/NEJMc1600337. ISSN 0028-4793.

[pmid12897322-6] Da-Silva SS, Sajan IS, Underwood JP (August 2003). "Congenital methemoglobinemia: a rare cause of cyanosis in the newborn--a case report". Pediatrics. 112 (2): e158–61. PMID 12897322.

[7] Bento C, McMullin MF, Percy M, et al. Primary Familial and Congenital Polycythemia. 2016 Nov 10. In: Adam MP, Ardinger HH, Pagon RA, et al., editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2018. Available from: https://www.ncbi.nlm.nih.gov/books/NBK395975/

[Hasselbalch2015-8] Hasselbalch, Hans Carl (2015). "Smoking as a contributing factor for development of polycythemia vera and related neoplasms". Leukemia Research. 39 (11): 1137–1145. doi:10.1016/j.leukres.2015.09.002. ISSN 0145-2126.

[MalenicaPrnjavorac2017-9] Malenica, Maja; Prnjavorac, Besim; Bego, Tamer; Dujic, Tanja; Semiz, Sabina; Skrbo, Selma; Gusic, Amar; Hadzic, Ajla; Causevic, Adlija (2017). "Effect of Cigarette Smoking on Haematological Parameters in Healthy Population". Medical Archives. 71 (2): 132. doi:10.5455/medarh.2017.71.132-136. ISSN 0350-199X.

[WuJuurlink2014-10] Wu, P. E.; Juurlink, D. N. (2014). "Carbon monoxide poisoning". Canadian Medical Association Journal. 186 (8): 611–611. doi:10.1503/cmaj.130972. ISSN 0820-3946.

[pmid3282731-11] Pollak R, Maddux MS, Cohan J, Jacobsson PK, Mozes MF (March 1988). "Erythrocythemia following renal transplantation: influence of diuretic therapy". Clin. Nephrol. 29 (3): 119–23. PMID 3282731.

[pmid1942342-12] Krauss DJ, Taub HA, Lantinga LJ, Dunsky MH, Kelly CM (December 1991). "Risks of blood volume changes in hypogonadal men treated with testosterone enanthate for erectile impotence". J. Urol. 146 (6): 1566–70. PMID 1942342.

[pmid9072584-13] Morales A, Johnston B, Heaton JP, Lundie M (March 1997). "Testosterone supplementation for hypogonadal impotence: assessment of biochemical measures and therapeutic outcomes". J. Urol. 157 (3): 849–54. PMID 9072584.

[Elliott20082-14] Elliott, S (2008). "Erythropoiesis-stimulating agents and other methods to enhance oxygen transport". British Journal of Pharmacology. 154 (3): 529–541. doi:10.1038/bjp.2008.89. ISSN 0007-1188.

[NadeemGui2012-15] Nadeem, Omar; Gui, Jiang; Ornstein, Deborah L. (2012). "Prevalence of Venous Thromboembolism in Patients With Secondary Polycythemia". Clinical and Applied Thrombosis/Hemostasis. 19 (4): 363–366. doi:10.1177/1076029612460425. ISSN 1076-0296.

[pmid2297568-16] Da Silva JL, Lacombe C, Bruneval P, Casadevall N, Leporrier M, Camilleri JP, Bariety J, Tambourin P, Varet B (February 1990). "Tumor cells are the site of erythropoietin synthesis in human renal cancers associated with polycythemia". Blood. 75 (3): 577–82. PMID 2297568.

[17] McDonald J, Pyeritz RE. Hereditary Hemorrhagic Telangiectasia. 2000 Jun 26 [Updated 2017 Feb 2]. In: Adam MP, Ardinger HH, Pagon RA, et al., editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2018. Available from: https://www.ncbi.nlm.nih.gov/books/NBK1351/

[1]

[2]

[3]

[4]

[5]

[6]

[7]

[8]

[9]

[10]

[11]

[12]

[13]

[14]

[15]

[16]

[17]

@@ Line 48: / Line 48: @@
 | align="left" style="background:#F5F5F5;" |
 * Autonomous erythrocyte production
-| align="center" style="background:#F5F5F5;" |JAK2 mutation > 95%
+| align="center" style="background:#F5F5F5;" |[[JAK2]] mutation (> 95%)
 | align="center" style="background:#F5F5F5;" | Mean age >60 years old
 | align="center" style="background:#F5F5F5;" | +
@@ Line 67: / Line 67: @@
 | align="center" style="background:#F5F5F5;" | ↑
 | align="left" style="background:#F5F5F5;" |
-* Painful erythema
+* Painful [[erythema]]
 | align="center" style="background:#F5F5F5;" | +
 | align="left" style="background:#F5F5F5;" |
@@ Line 90: / Line 90: @@
 ! align="center" style="background:#DCDCDC;" |Chuvash polycythemia<ref name="ZhouKnoche2016">{{cite journal|last1=Zhou|first1=Amy W.|last2=Knoche|first2=Eric M.|last3=Engle|first3=Elizabeth K.|last4=Ban-Hoefen|first4=Makiko|last5=Kaiwar|first5=Charu|last6=Oh|first6=Stephen T.|title=Clinical Improvement with JAK2 Inhibition in Chuvash Polycythemia|journal=New England Journal of Medicine|volume=375|issue=5|year=2016|pages=494–496|issn=0028-4793|doi=10.1056/NEJMc1600337}}</ref>
 | align="center" style="background:#F5F5F5;" | Hypoxia-sensing disorder
-| align="center" style="background:#F5F5F5;" | VHL mutation
+| align="center" style="background:#F5F5F5;" | [[VHL gene|VHL]] mutation
 | align="center" style="background:#F5F5F5;" | Russia, Italy
 <40 years old
@@ Line 101: / Line 101: @@
 | align="left" style="background:#F5F5F5;" |
 * [[Pruritis]]
-* Dizziness
+* [[Dizziness]]
 | align="center" style="background:#F5F5F5;" | Facial plethora
 | align="center" style="background:#F5F5F5;" | ↓
@@ Line 107: / Line 107: @@
 | align="center" style="background:#F5F5F5;" | ↑
 | align="left" style="background:#F5F5F5;" |
-* Painful erythema
+* Painful [[erythema]]
 | align="center" style="background:#F5F5F5;" | +
 | align="left" style="background:#F5F5F5;" |
@@ Line 120: / Line 120: @@
 | align="center" style="background:#F5F5F5;" | Molecular genetic testing
 | align="left" style="background:#F5F5F5;" |
-* Multiple thrombotic events
+* Multiple [[thrombotic events]]
 |-
 ! align="center" style="background:#DCDCDC;" |Hereditary [[methemoglobinemia]]<ref name="pmid12897322">{{cite journal |vauthors=Da-Silva SS, Sajan IS, Underwood JP |title=Congenital methemoglobinemia: a rare cause of cyanosis in the newborn--a case report |journal=Pediatrics |volume=112 |issue=2 |pages=e158–61 |date=August 2003 |pmid=12897322 |doi= |url=}}</ref>
 | align="left" style="background:#F5F5F5;" |
-* Cytochrome b5 reductase deficiency
+* [[Cytochrome b5 reductase]] deficiency
 * Hemoglobin M disease
 | align="center" style="background:#F5F5F5;" | Mutations in globin gene
@@ Line 136: / Line 136: @@
 | align="center" style="background:#F5F5F5;" | [[Cyanosis]]
 | align="center" style="background:#F5F5F5;" | Inaccurately Nl
-| align="center" style="background:#F5F5F5;" | -
+| align="center" style="background:#F5F5F5;" | −
 | align="center" style="background:#F5F5F5;" | Nl
 | align="center" style="background:#F5F5F5;" | −
 | align="center" style="background:#F5F5F5;" | −
 | align="left" style="background:#F5F5F5;" |
-* Altered mental status
+* [[Altered mental status]]
 | align="center" style="background:#F5F5F5;" | ↑
 | align="center" style="background:#F5F5F5;" | ↑
@@ Line 153: / Line 153: @@
 |-
 ! align="center" style="background:#DCDCDC;" |Primary familial and congenital polycythemia<ref>Bento C, McMullin MF, Percy M, et al. Primary Familial and Congenital Polycythemia. 2016 Nov 10. In: Adam MP, Ardinger HH, Pagon RA, et al., editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2018. Available from: https://www.ncbi.nlm.nih.gov/books/NBK395975/</ref>
-| align="center" style="background:#F5F5F5;" | Autosomal dominant inheritance
+| align="center" style="background:#F5F5F5;" | [[Autosomal dominant]] inheritance
 | align="center" style="background:#F5F5F5;" | EPOR mutation
 | align="center" style="background:#F5F5F5;" | Very rare
@@ Line 164: / Line 164: @@
 | align="center" style="background:#F5F5F5;" | Facial plethora
 | align="center" style="background:#F5F5F5;" |Nl
-| align="center" style="background:#F5F5F5;" | -
+| align="center" style="background:#F5F5F5;" | −
 | align="center" style="background:#F5F5F5;" | Nl to ↑
 | align="center" style="background:#F5F5F5;" | −
 | align="center" style="background:#F5F5F5;" | −
 | align="left" style="background:#F5F5F5;" |
-* Altered mental status
+* [[Altered mental status]]
 | align="center" style="background:#F5F5F5;" | ↑
 | align="center" style="background:#F5F5F5;" | ↑
@@ Line 176: / Line 176: @@
 | align="center" style="background:#F5F5F5;" | Nl to ↓
 | align="center" style="background:#F5F5F5;" | NA
-| align="center" style="background:#F5F5F5;" | Isolated erythrocytosis + genetic testing
+| align="center" style="background:#F5F5F5;" | Isolated [[erythrocytosis]] + [[genetic testing]]
 | align="left" style="background:#F5F5F5;" |
 * Mild manifestations of hyperviscosity
@@ Line 248: / Line 248: @@
 | align="center" style="background:#F5F5F5;" | −
 | align="left" style="background:#F5F5F5;" |
-* Dizziness
+* [[Dizziness]]
-* Altered cognition
+* [[Altered mental state|Altered cognition]]
 | align="center" style="background:#F5F5F5;" | [[Cyanosis]], flushed cheeks
 | align="center" style="background:#F5F5F5;" |Nl
@@ Line 270: / Line 270: @@
 | align="left" style="background:#F5F5F5;" |
 * Reduced plasma volume
-| align="center" style="background:#F5F5F5;" | -
+| align="center" style="background:#F5F5F5;" | −
 | align="center" style="background:#F5F5F5;" |Any
-| align="center" style="background:#F5F5F5;" | -
+| align="center" style="background:#F5F5F5;" | −
-| align="center" style="background:#F5F5F5;" | -
+| align="center" style="background:#F5F5F5;" | −
-| align="center" style="background:#F5F5F5;" | -
+| align="center" style="background:#F5F5F5;" | −
-| align="center" style="background:#F5F5F5;" | -
+| align="center" style="background:#F5F5F5;" | −
-| align="center" style="background:#F5F5F5;" | -
+| align="center" style="background:#F5F5F5;" | −
 | align="left" style="background:#F5F5F5;" |
-* Dizziness
+* [[Dizziness]]
 | align="center" style="background:#F5F5F5;" |Nl
 | align="center" style="background:#F5F5F5;" | Nl
-| align="center" style="background:#F5F5F5;" | -
+| align="center" style="background:#F5F5F5;" | −
 | align="center" style="background:#F5F5F5;" | Nl to ↓
-| align="center" style="background:#F5F5F5;" | -
+| align="center" style="background:#F5F5F5;" | −
-| align="center" style="background:#F5F5F5;" | -
+| align="center" style="background:#F5F5F5;" | −
-| align="center" style="background:#F5F5F5;" | -
+| align="center" style="background:#F5F5F5;" | −
 | align="center" style="background:#F5F5F5;" | ↑
 | align="center" style="background:#F5F5F5;" |Nl
@@ Line 299: / Line 299: @@
 * Reduced plasma volume
 * Accelerated [[erythropoiesis]]
-| align="center" style="background:#F5F5F5;" | -
+| align="center" style="background:#F5F5F5;" | −
 | align="center" style="background:#F5F5F5;" | Athletes
-| align="center" style="background:#F5F5F5;" | -
+| align="center" style="background:#F5F5F5;" | −
 | align="center" style="background:#F5F5F5;" | +
 | align="center" style="background:#F5F5F5;" | +
-| align="center" style="background:#F5F5F5;" | -
+| align="center" style="background:#F5F5F5;" | −
-| align="center" style="background:#F5F5F5;" | -
+| align="center" style="background:#F5F5F5;" | −
-| align="center" style="background:#F5F5F5;" | -
+| align="center" style="background:#F5F5F5;" | −
 | align="center" style="background:#F5F5F5;" | [[Acne vulgaris|Acne]] and [[hirsutism]]
 | align="center" style="background:#F5F5F5;" | Nl
-| align="center" style="background:#F5F5F5;" | -
+| align="center" style="background:#F5F5F5;" | −
 | align="center" style="background:#F5F5F5;" |Nl to ↑
-| align="center" style="background:#F5F5F5;" | -
+| align="center" style="background:#F5F5F5;" | −
-| align="center" style="background:#F5F5F5;" | -
+| align="center" style="background:#F5F5F5;" | −
 | align="left" style="background:#F5F5F5;" |
-* Gynecomastia
+* [[Gynecomastia]]
 | align="center" style="background:#F5F5F5;" | ↑
 | align="center" style="background:#F5F5F5;" | ↑
@@ Line 326: / Line 326: @@
 * [[Cardiomegaly|Cardiac hypertrophy]]
 |-
-! align="center" style="background:#DCDCDC;" |Self-injection of [[erythropoietin]]<ref name="Elliott20082">{{cite journal|last1=Elliott|first1=S|title=Erythropoiesis-stimulating agents and other methods to enhance oxygen transport|journal=British Journal of Pharmacology|volume=154|issue=3|year=2008|pages=529–541|issn=00071188|doi=10.1038/bjp.2008.89}}</ref>
+! align="center" style="background:#DCDCDC;" |Self−injection of [[erythropoietin]]<ref name="Elliott20082">{{cite journal|last1=Elliott|first1=S|title=Erythropoiesis-stimulating agents and other methods to enhance oxygen transport|journal=British Journal of Pharmacology|volume=154|issue=3|year=2008|pages=529–541|issn=00071188|doi=10.1038/bjp.2008.89}}</ref>
 | align="left" style="background:#F5F5F5;" |
 * Reduced plasma volume
 * Accelerated [[erythropoiesis]]
-| align="center" style="background:#F5F5F5;" | -
+| align="center" style="background:#F5F5F5;" | −
 | align="center" style="background:#F5F5F5;" | Athletes
-| align="center" style="background:#F5F5F5;" | -
+| align="center" style="background:#F5F5F5;" | −
 | align="center" style="background:#F5F5F5;" | +
 | align="center" style="background:#F5F5F5;" | +
-| align="center" style="background:#F5F5F5;" | -
+| align="center" style="background:#F5F5F5;" | −
-| align="center" style="background:#F5F5F5;" | -
+| align="center" style="background:#F5F5F5;" | −
-| align="center" style="background:#F5F5F5;" | -
+| align="center" style="background:#F5F5F5;" | −
 | align="center" style="background:#F5F5F5;" | Muscular
 | align="center" style="background:#F5F5F5;" | ↓
-| align="center" style="background:#F5F5F5;" | -
+| align="center" style="background:#F5F5F5;" | −
 | align="center" style="background:#F5F5F5;" |↑
-| align="center" style="background:#F5F5F5;" | -
+| align="center" style="background:#F5F5F5;" | −
-| align="center" style="background:#F5F5F5;" | -
+| align="center" style="background:#F5F5F5;" | −
-| align="center" style="background:#F5F5F5;" | -
+| align="center" style="background:#F5F5F5;" | −
 | align="center" style="background:#F5F5F5;" | ↑
 | align="center" style="background:#F5F5F5;" | ↑
@@ Line 356: / Line 356: @@
 * [[Stroke]]
 * [[Thrombosis|Thromboembolic disease]]
-* antibody-mediated anemia
+* Antibody-mediated anemia
 |-
 ! rowspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Secondary causes
@@ Line 433: / Line 433: @@
 | align="center" style="background:#F5F5F5;" |ACVRL1, ENG, GDF2, SMAD4 mutation
 | align="center" style="background:#F5F5F5;" |Children
-| align="center" style="background:#F5F5F5;" | -
+| align="center" style="background:#F5F5F5;" | −
 | align="center" style="background:#F5F5F5;" | +
 | align="center" style="background:#F5F5F5;" | +
 | align="center" style="background:#F5F5F5;" | [[Gastrointestinal bleeding|GI bleeding]]
-| align="center" style="background:#F5F5F5;" | -
+| align="center" style="background:#F5F5F5;" | −
 | align="left" style="background:#F5F5F5;" |
 * [[Epistaxis]]
@@ Line 443: / Line 443: @@
 | align="center" style="background:#F5F5F5;" |Multiple [[telangiectasia]] on face, extremities, and body
 | align="center" style="background:#F5F5F5;" | Nl to ↓
-| align="center" style="background:#F5F5F5;" | -
+| align="center" style="background:#F5F5F5;" | −
 | align="center" style="background:#F5F5F5;" | Nl
-| align="center" style="background:#F5F5F5;" | -
+| align="center" style="background:#F5F5F5;" | −
-| align="center" style="background:#F5F5F5;" | -
+| align="center" style="background:#F5F5F5;" | −
-| align="center" style="background:#F5F5F5;" | -
+| align="center" style="background:#F5F5F5;" | −
 | align="center" style="background:#F5F5F5;" | ↑/↓
 | align="center" style="background:#F5F5F5;" | ↑/↓

Polycythemia differential diagnosis: Difference between revisions

Revision as of 14:01, 24 August 2018

Overview

Differential Diagnosis of Polycythemia

References

Navigation menu

Search