Polycythemia diagnostic study of choice: Difference between revisions
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{{CMG}}; {{AE}}{{Debduti}} | {{CMG}}; {{AE}}{{Debduti}} | ||
== Overview == | == Overview == | ||
*History and physical examination. | |||
*Blood evaluation in association with genetic mutation study for relevant mutation. | |||
*Imaging for splenomegaly. | |||
== Diagnostic Study of Choice == | == Diagnostic Study of Choice == | ||
Revision as of 21:57, 10 December 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Debduti Mukhopadhyay, M.B.B.S[2]
Overview
- History and physical examination.
- Blood evaluation in association with genetic mutation study for relevant mutation.
- Imaging for splenomegaly.
Diagnostic Study of Choice
Study of choice
- The polycythemia vera study group is considered to be the gold standard test for the diagnosis of polycythemia vera; however, it does not take into account bone marrow histopathology. [1]
- Clinical features that significantly differentiate primary vs secondary polycythemia are: splenomegaly, thrombocyte count, LDH, LAP, and erythropoietin. [2]
- Diagnostic criteria for polycythemia vera:
- JAK2 positive polycythemia vera
A1.Hematocrit >0.52 in men, >0.48 in women OR; red cell mass >25% above predicted. A2.Mutation in JAK2
Both criteria must be present for a diagnosis.
- JAK2 negative polycythemia vera
A1.Increased RBC mass >25% above predicted OR; Hct >0.60 in men and >0.56 in women. A2.Absence of a JAK2 mutation. A3.Absent secondary erythrocytosis causes. A4.Splenomegaly that is palpable on physical examination. A5.Evidence of an acquired mutation (except BCR-ABL) in the hematopoietic cells. B1.Thrombocytosis (>450 x 109) B2.Neutrophilic leukocytosis (>10 x 109 in smokers, >12.5 x 109 in non-smokers). B3.Evidence of splenomegaly on imaging. B4.Reduced serum erythropoietin or colonies of endogenous erythroid cells.
A1 + A2 + A3 plus either one more A or two B criteria must be present for diagnosis. [3]
References
- ↑ Thiele J, Kvasnicka HM (January 2005). "Diagnostic impact of bone marrow histopathology in polycythemia vera (PV)". Histol Histopathol. 20 (1): 317–28. doi:10.14670/HH-20.317. PMID 15578448.
- ↑ Thiele J, Kvasnicka HM, Zankovich R, Diehl V (April 2001). "The value of bone marrow histology in differentiating between early stage Polycythemia vera and secondary (reactive) Polycythemias". Haematologica. 86 (4): 368–74. PMID 11325641.
- ↑ "The classification and diagnosis of erythrocytosis - McMULLIN - 2008 - International Journal of Laboratory Hematology - Wiley Online Library".