Polycythemia Vera (PV) is an uncommon condition in which the body makes too many Red Blood Cells (RBCs). Most cases occur over 50-years-old, and are discovered accidentally when a Complete Blood Count (CBC) is drawn for other reasons. Some patients with PV have vague symptoms like fatigue. Others may have unusual symptoms, like unbearably intense itching after a hot shower, burning hands or feet along with color changes in the skin there, or weird visual changes like flashing lights or floaters.
The danger is that the too many RBCs cause stagnant blood flow, which in the brain can cause Strokes. Diagnosis begins with a CBC. We may suspect PV if the hemoglobin is >16.5 gm and hematocrit >50% on two or more tests, and no other conditions exist that would cause such numbers. We’d especially suspect it if WBC’s & Platelets are also very high, if the patient has any of the above symptoms, or if we find an enlarged spleen. In such cases, we refer to a Hematologist for special testing.
The main dangers of Polycythemia are Strokes on the one hand, and the eventual development of Leukemia or other blood diseases. In the past, most patients died by 2 years after diagnosis, but today’s treatments help them live much longer.