Polycythemia vera
| Polycythemia vera | |
| ICD-10 | D45 |
|---|---|
| ICD-9 | 238.4 |
| ICD-O: | 9950/3 |
| MeSH | D011087 |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Polycythemia vera Microchapters |
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Overview
Epidemiology & Demographics
Polycythemia vera occurs in all age groups (including children),[1] although the incidence increases with age. One study found the median age at diagnosis to be 60 years,[2] while a study in Olmsted County, Minnesota found that the highest incidence was in people aged 70–79 years.[3] The overall incidence in the Minnesota population was 1.9 per 100,000 person-years, and the disease was more common in men than women.[3]
History & Symptoms
Patients with polycythemia vera are often asymptomatic. A classic symptom of polycythemia vera is generalized itching, particularly after exposure to warm water, which may be due to abnormal histamine release[4][5] or prostaglandin production.[6] Such itching is present in approximately 40% of patients with polycythemia vera.[2] Gouty arthritis may be present in up to 20% of patients.[2] Peptic ulcer disease is also common in patients with polycythemia vera; the reasons for this are unclear, but may be related to an increased susceptibility to infection with the ulcer-causing bacterium H. pylori.[7]
A rare but classic symptom of polycythemia vera (and the related myeloproliferative disease essential thrombocythemia) is erythromelalgia.[8] This is a sudden, severe burning pain in the hands or feet, usually accompanied by a reddish or bluish coloration of the skin. Erythromelalgia is caused by an increased platelet count or increased platelet "stickiness", resulting in the formation of tiny blood clots in the vessels of the extremity; it responds rapidly to treatment with aspirin.[9][10]
Patients with polycythemia vera are prone to the development of blood clots (thrombosis). A major thrombotic complication (e.g. heart attack, stroke, deep venous thrombosis, or Budd-Chiari syndrome) may sometimes be the first symptom or indication that a person has polycythemia vera.
Diagnosis
Lab Tests
Treatment
Medical Therapy
External links
- Myeloproliferative Disease Support Group, since 1994
- Myeloproliferative Disorders (CMPD Education Foundation)
- MPD Foundation and Research Alliance - Register for a free newsleter
References
- ↑ Passamonti F, Malabarba L, Orlandi E, Baratè C, Canevari A, Brusamolino E, Bonfichi M, Arcaini L, Caberlon S, Pascutto C, Lazzarino M (2003). "Polycythemia vera in young patients: a study on the long-term risk of thrombosis, myelofibrosis and leukemia". Haematologica. 88 (1): 13–8. PMID 12551821.
- ↑ 2.0 2.1 2.2 Berlin, NI. (1975). "Diagnosis and classification of polycythemias". Semin Hematol 12: 339.
- ↑ 3.0 3.1 Anía B, Suman V, Sobell J, Codd M, Silverstein M, Melton L (1994). "Trends in the incidence of polycythemia vera among Olmsted County, Minnesota residents, 1935-1989". Am J Hematol. 47 (2): 89–93. PMID 8092146.
- ↑ Steinman H, Kobza-Black A, Lotti T, Brunetti L, Panconesi E, Greaves M (1987). "Polycythaemia rubra vera and water-induced pruritus: blood histamine levels and cutaneous fibrinolytic activity before and after water challenge". Br J Dermatol. 116 (3): 329–33. PMID 3567071.
- ↑ Jackson N, Burt D, Crocker J, Boughton B (1987). "Skin mast cells in polycythaemia vera: relationship to the pathogenesis and treatment of pruritus". Br J Dermatol. 116 (1): 21–9. PMID 3814512.
- ↑ Fjellner B, Hägermark O (1979). "Pruritus in polycythemia vera: treatment with aspirin and possibility of platelet involvement". Acta Derm Venereol. 59 (6): 505–12. PMID 94209.
- ↑ Torgano G, Mandelli C, Massaro P, Abbiati C, Ponzetto A, Bertinieri G, Bogetto S, Terruzzi E, de Franchis R (2002). "Gastroduodenal lesions in polycythaemia vera: frequency and role of Helicobacter pylori". Br J Haematol. 117 (1): 198–202. PMID 11918555.
- ↑ van Genderen P, Michiels J (1997). "Erythromelalgia: a pathognomonic microvascular thrombotic complication in essential thrombocythemia and polycythemia vera". Semin Thromb Hemost. 23 (4): 357–63. PMID 9263352.
- ↑ Michiels J (1997). "Erythromelalgia and vascular complications in polycythemia vera". Semin Thromb Hemost. 23 (5): 441–54. PMID 9387203.
- ↑ Landolfi R, Ciabattoni G, Patrignani P, Castellana M, Pogliani E, Bizzi B, Patrono C (1992). "Increased thromboxane biosynthesis in patients with polycythemia vera: evidence for aspirin-suppressible platelet activation in vivo". Blood. 80 (8): 1965–71. PMID 1327286.