Shi Shurong’s consultation appointment: these symptoms appear in the middle-aged and elderly people, be careful “true red”!

The progression of polycythemia vera is slow, the early symptoms are not obvious, and even some patients are asymptomatic. Therefore, the condition is easily overlooked, and as the condition progresses, the symptoms become more and more obvious, and the treatment becomes more and more difficult. Director Shi Shurong’s WeChat Consultation Platform: Although the exact cause of polycythemia vera is not clear yet, we can judge whether we have polycythemia vera by the following “clip trails”: ① due to too many red blood cells, the blood viscosity will increase, Slow blood flow and tissue hypoxia cause congestion and expansion of tiny blood vessels throughout the body. Most patients have reddish purple faces and red skin on the hands and feet, similar to drunken appearance. Many patients will have high blood pressure, numbness in hands and feet, dizziness and headache . ② About 3/4 of the patients can feel a hard mass in the left upper abdomen, which is a sign of splenomegaly. ③ As the blood flow slows down, the probability of thrombosis will also increase, and many patients will have embolism of the heart, brain, and pulmonary blood vessels, and severe symptoms such as fainting, angina, and dyspnea will occur. Special reminder: 30-30 year olds should be vigilant if they have the above performance, and see a doctor in time. So, what test do you suspect polycythemia vera? Some patients may already have symptoms (such as dark red face, high blood pressure, numbness of hands and feet, etc.), but the blood routine shows that the number of red blood cells is still at a normal level or only slightly increased. At this time, the doctor will tell the patient to observe for a period of time before the examination. In order to avoid delays in treatment, some doctors will recommend patients to undergo bone marrow examination, which generally shows that the hyperplasia is obviously active, and the granulocyte, red and megakaryocyte cell lines are all hyperplastic, and the erythroid hyperplasia is significant. In addition, in some cases, a chromosomal examination is also required. Most patients can detect mutations in the JAK2V617F gene on exon 14. For more patient communication help, you can follow the WeChat public account: True Red Patient Club

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

Shi Shurong’s medical remarks: The progress of Zhenhong’s condition is slow, does it mean that it is not serious?

Polycythemia vera is not common in our daily life, and even because we don’t know much about this disease, it leads to neglect of the condition, especially in the early stage of the disease, because the symptoms are not obvious or atypical, and often ignore its existence . But in the later stages of the disease, its harm should not be underestimated! Director Shi Shurong’s WeChat account zkxk9999 is really red? Polycythemia vera is characterized by erythrocytosis, which is also accompanied by an increase in platelets. The middle-aged and elderly population is the main disease group. However, the initial symptoms of patients with polycythemia vera are relatively mild, and the disease progresses very slowly. It is easy to ignore the condition and even miss the best treatment opportunity. In fact, the true red condition is not as general as the initial performance. If the treatment is not timely, the following conditions are likely to occur: the onset of true polycythemia is hidden, and early symptoms after the onset of patients will appear dizziness, fatigue, headache, sweating and other symptoms. As the disease progresses, the patient suffers from hemiplegia and myocardial infarction after thrombosis. Some patients also have nosebleeds and ecchymosis on the skin and mucous membranes. Increased histamine release can cause gastrointestinal bleeding. Increased blood volume can cause hepatosplenomegaly. If severe symptoms occur, the patient should go to the hospital for treatment and treatment as soon as possible, otherwise it will be life-threatening. Experts remind that polycythemia vera is a bone marrow tumor. If left untreated, as the disease progresses, some patients can be converted into bone marrow fibrosis or even acute leukemia. Therefore, once a true red patient is diagnosed, he must actively take treatment measures to control the progress of the disease in a timely manner. For more erythrocytosis disease knowledge or patient help, you can pay attention to WeChat public number: zkxy120

Can lucotinib treat polycythemia vera? Shi Shurong’s appointment

Polycythemia vera is a proliferative tumor of the bone marrow. The salient features of the disease are: the number of red blood cells, hemoglobin, hematocrit, and total blood volume significantly exceed normal levels. Director Shi Shurong’s micro-signal xueyeke999 Although the clinical manifestations of polycythemia vera are not obvious at the early stage, even many patients ignore the development of the disease, but if the disease is not effectively controlled, it is easy to cause thrombosis and the risk of sudden cardiovascular disease Increased, and patients will be accompanied by skin itching, fatigue, night sweats and other symptoms, and some patients will also be accompanied by splenomegaly. How to treat “true red”? Currently, the main therapeutic goal of polycythemia vera is to prevent thrombotic events while avoiding iatrogenic damage, and to reduce the risk of conversion to myelofibrosis and acute myeloid leukemia. ① Most patients receive low-dose aspirin and intravenous bloodletting to achieve the goal of hematocrit (Hct) of less than 45%, which can reduce thrombotic events and deaths due to cardiovascular events. ② Cell-reducing therapy: For high-risk patients with thrombotic events, patients with persistent and progressive hematological abnormalities, splenomegaly, symptomatic, and patients who cannot tolerate bleeding or need to bleed frequently, cell-reducing therapy is often recommended. The first-line cell-reducing drug is hydroxyurea, but some patients cannot obtain sufficient efficacy or cannot tolerate the side effects caused by the treatment amount. For such patients, there is no clinically effective alternative treatment plan, so as long as the patient can benefit from the treatment, the clinician continues to choose hydroxyurea treatment. As a JAK1 / 2 gene inhibitor, lucotinib has been shown in phase II clinical trials to benefit clinically patients with PV. At the same time, to evaluate PV patients who have sufficient response to hydroxyurea or cannot tolerate it due to side effects, Rucatinib can better control HCT and reduce spleen volume and improve related symptoms than standard treatment. When taking rucotinib, it should be noted that a complete blood cell count must be taken before using lucotinib. The initial blood test must be performed every 2-4 weeks. The dose should be adjusted according to clinical and laboratory indicators until the dose is stabilized. Welcome to pay attention to the WeChat public account of the True Red Patient Association: zkxy120

Is polycythemia vera severe? How to treat? Shi Shurong consultation appointment

Polycythemia vera is not common in daily life, and people do not know much about this disease. Many newly diagnosed patients do not know what kind of polycythemia is. Is it serious? Director Shi Shurong’s so-called “true red” micro-signal xueyeke999 is actually a bone marrow proliferative disease, a relatively serious chronic blood disease. Although the disease progresses slowly, but if it is not treated in time, the progression of the disease to the later stage will constitute a life threat! Clinically, the treatment methods for polycythemia vera include the following types: 1. Venous bloodletting: The operation of venous bloodletting is simple, and the patient can operate according to the correct method at home. After bleeding, the patient’s blood volume decreases and it is not easy to form a thrombus. The amount of bloodletting should be appropriate, about 400ml each time, the number of bloodletting is not too much, 1-3 times a day. Elderly patients should be cautious about bleeding, and should go to the hospital for bleeding, because the elderly are weak and have unstable blood pressure. Excessive bleeding will cause syncope and even shock. In addition, long-term bloodletting treatment is prone to anemia, or thrombosis due to decreased blood volume. 2. Chemotherapy: It is suitable for those with severe disease and obvious enlargement of liver and spleen, as well as those with gastrointestinal discomfort, itching and embolism. If the patient has a thrombosis, this treatment can also be used. Commonly used drugs are hematopoietic inhibitors, such as hydroxyurea, interferon, busulfan, chlorambucil, cyclophosphamide, phenylalanine chlorambucil, cephalotaxine. Patients with aggravated conditions generally take more of the above treatments. After taking the drug, the patient’s blood cell value can be temporarily controlled, and patients often need long-term or even lifelong medication. The so-called lifelong medication is not based on the life expectancy of a normal person, but on the patient’s lifespan for a few years. It must be used for a few years, and this drug cannot prevent the progression of the disease from developing into leukemia. In addition, during medication, patients are likely to develop drug resistance or unbearable drug-related hematological toxicity, such as skin and mucosal lesions, gastrointestinal reactions, pneumonia, liver and kidney damage, or increased bleeding. Integrated Chinese and Western medicine treatment: The intervention of Chinese medicine can reduce the side effects of chemotherapy drugs. Differentiation of syndromes in traditional Chinese medicine can reduce red blood cells as soon as possible to maintain Hct in a safe range. The combination of traditional Chinese and western medicine can reduce the risk of complications and reduce the risk of conversion to acute leukemia! 【More disease knowledge pay attention to WeChat public number : True Red Patient Club】 Welcome to follow Shi Shurong to consult and make an appointment for the public account to learn more: zzb753