Polisitemia Vera ve İzole Hemoglobin/Hematokrit Yüksekliği

Abstract

Erythrocytosis is a common finding in clinical practice. Polycythemia vera (PV) is one of the must-be-ruled-out diseases that causes erythrocytosis and life-threatening complications such as thrombosis, hemorrhage, transformation to leukemia/myelofibrosis. For diagnosis; EPO levels, JAK2 analysis and bone marrow biopsy are indicated. In our study; we aim to detect patients with high hemoglobin (Hb)/hematocrit (Hct) levels that should be examined for EPO, JAK2 analysis and bone marrow biopsy; as we consider the un-availability of these tests in all health-centers and increased costs due to unnecessary tests. 72 patients diagnosed with PV in 1986-2019 were included to our study for PV group and 330 patients examined for high Hb/Hct levels and PV ruled out in 2016-2019 were included for other high Hb/Hct (DE) group. In PV group mean age was 53,1 (13,2), 56% were males. In DE group it was 45,0 (16,9), 81% were males. At the time of diagnosis mean Hb was 17,2 g/dL, Hct was 52,2%, leukocytes were 13.144/L, thrombocytes were 507.444/L for PV group, mean Hb was 17,5 g/dL, Hct was 51,6%, leukocytes were 7.771/L, thrombocytes were 221.824/L in DE group. When both groups were compared; we detected more leukocytosis, thrombocytosis, splenomegaly, thrombosis, iron deficiency and low EPO levels accompanying in PV group (p<0,05). Detection of isolated high Hb/Hct was 19% in PV group. In 2016-2019 among patients presenting with high Hb/Hct, 5% were diagnosed with PV and 95% were considered as DE. Leukocytosis/thrombocytosis was found in 76,4% of PV diagnosed patients. 4 (1% in all patients in study, %23,6 in PV diagnosed patients) of PV patients were applied to hospital with isolated high Hb/Hct levels; 1 of them had splenomegaly, 1 had iron deficiency and 1 had venous thrombosis. 1 had no clues pointing PV. So, we detected the ratios of PV patients with and without any findings suggesting PV other than isolated high Hb/Hct levels as %6 and 0,04% respectively. It is appropriate that; for searching PV in patients with high Hb/Hct levels, we should first examine the possibility of accompanying leukocytosis, thrombocytosis, splenomegaly, thrombosis and iron deficiency; if none is detected we should not go further for PV tests.