Polycythemia, thick blood, a serious problem that requires urgent treatment

What kind of symptoms… are called ‘Polycythemia’?

Generally, the symptoms can include headache, dizziness, nausea, vomiting, fatigue, weakness, visual disturbances, abnormal facial redness, easy tiredness, and chest tightness. However, some groups may have no preceding symptoms but are found to have abnormalities through a CBC (Complete Blood Count) blood test.

‘Polycythemia’… what causes it?

Polycythemia has several types, each classified according to the cause of the symptoms, such as being overweight, smoking, heavy alcohol consumption, problems with blood cell production, or as a result of various diseases. The details are as follows:

• Polycythemia caused by decreased blood volume or plasma volume (Apparent Polycythemia) is often caused by being overweight, smoking, heavy alcohol consumption, use of diuretics, or dehydration.
• Polycythemia caused by the bone marrow producing too many red blood cells (Absolute Polycythemia) can be divided into 2 types as follows:

1. 1. Abnormal overproduction of red blood cells by the bone marrow (Primary Polycythemia or Polycythemia Vera) which is often related to a mutation in the JAK2 gene, causing the bone marrow to produce an abnormally high number of red blood cells, as well as an increased number of white blood cells and platelets. It usually occurs in the elderly.
   2. Excessive production of erythropoietin hormone (Secondary Polycythemia) or may occur due to other causes such as:

• • • Chronic Obstructive Pulmonary Disease (COPD) and Sleep Apnoea cause insufficient oxygen supply to tissues throughout the body, leading to increased production of erythropoietin hormone.
    • Kidney-related problems such as kidney tumors or narrowing of the renal arteries, etc.

How is polycythemia detected?

There are 5 methods to test for polycythemia, but the 3 most commonly used methods are complete blood count, blood smear, and erythropoietin test. Details are as follows:

• Complete Blood Count (CBC) measures the number of red blood cells, white blood cells, platelets, hemoglobin concentration in red blood cells, and the volume of red blood cells.
• Blood Smear shows the characteristics of red blood cells, allowing detection of abnormal blood cells that may be related to this disease.
• Erythropoietin Test in patients with polycythemia may show abnormal levels of erythropoietin hormone in the blood.
• Bone Marrow Examination involves aspiration and biopsy of bone marrow tissue, which is then analyzed by specialists. Patients with polycythemia often have an increased number of blood cells.
• JAK2 Genetic Mutation Test Approximately 95% of patients with polycythemia caused by abnormal bone marrow function are associated with JAK2 genetic mutation (Polycythemia Vera), which can be detected through blood tests and bone marrow aspiration and biopsy.

How is polycythemia treated?

Treatment varies depending on the physician’s judgment, ranging from bloodletting to medications that reduce blood cell production, aiming to improve symptoms and reduce the risk of future blood clots.