Shi Shurong’s medical words: What abnormalities do patients with polycythemia have?

Polycythemia vera is not common in daily life, and many patients do not know much about the disease. They think that the high red blood cell value is true red. In fact, the characteristic of true red is not only that the red blood cells are too high, and only checking the blood routine can not confirm the true red! Director Shi Shurong’s consultation on WeChat zkxk9999 consultation: physical examination blood routinely found that red blood cells and hemoglobin are high, more than 180 hemoglobin, but my body has no symptoms at all, is it true polycythemia? Medical Answer: General blood routine examination of red blood cells and hemoglobin is abnormally high, and may be suspected of polycythemia, but whether it can be diagnosed as polycythemia vera, simple blood routine examination can not be finalized, in addition to the patient’s physical manifestations, but also with Comprehensive analysis of other relevant inspection results. So, what abnormalities do people with polycythemia have? First of all, patients with signs and symptoms are more common in the middle-aged and elderly people, often found due to headaches, limb numbness and other symptoms. Routine blood tests: mainly red blood cell count, hematocrit, increased red blood cell volume and hemoglobin, hematocrit is 60% male and 55% female patients often have an absolute increase in red blood cell volume. Therefore, these patients can not do red blood cell volume check. About 50% of patients are accompanied by increased white blood cell and platelet counts. Bone marrow elephant: Early patients with red blood cells often exhibit iron-deficient morphological features, low pigment in small cells, and late bone marrow fibrosis, which can have significant large and small unevenness and teardrop-shaped red blood cells. In advanced patients, intermediate and late granulocytes can be seen, and about 23 patients can have increased basophils. Giant blood platelets are often seen in peripheral blood smears. Bone marrow examinations are often hyperproliferative in three lines and may have reticular fibrosis. The neutrophil alkaline phosphatase level is increased in about 70% of patients, the serum VitB12 concentration is increased in 40% of patients, the serum VitB12 binding protein is increased in 70% of patients, most patients have elevated uric acid and histamine levels, and arterial PO is usually more normal People are low. Whole blood viscosity often increases. Serum EPO levels are reduced or normal low values. Patients with normal PT, aPT and normal fibrinogen platelet counts of 1000X109L may have acquired VWD similar to type II VWD), with extended bleeding time, ⅧC: normal VWF, reduced activity of co-factors of ristocetin, and large VWF. The number of aggregates is reduced or missing. Some patients have deficiency of antithrombin Ⅲ, protein C and protein S. The above is about the common symptoms of polycythemia vera, and the examination of blood and bone marrow. Finally, it is emphasized that the late stage of true red disease is very harmful to the health of patients. Therefore, once the diagnosis is confirmed, it must be actively treated without delay! For more erythrocytosis disease knowledge or patient help, you can pay attention to WeChat public number: zkxy120