Polycythemia - How Too Many Red Blood Cells Can Be A Problem?

Polycythemia - How Too Many Red Blood Cells Can Be A Problem?

Most of us know at least know that red blood cells are good. And normally when we think about problems in red blood cells, the first thing pops up in the mind is anemia disorder which is actually low amount of red blood cells. But what when someone has too many red blood cells? What does it indicate? Is it a problem or a normal thing?

These are some of the questions that would naturally arise but it’s actually a disease known as polycythemia or erythrocytosis.

What is polycythemia?

Naturally, in terms of positive things, we believe more is better than not enough. But in case of polycythemia, it’s not good. Polycythemia is a blood disorder in which red blood cells are overproduced. 

This thickens the blood due to the high amount of cells that in turn makes difficult for the blood to flow through the vessels normally. Too many red blood cells can cause heart attack, stroke and blood clot in the lung.

What causes polycythemia?

Polycythemia or polycythemia vera occurs from a genetic mutation called JAK2. This gene is responsible for directing the bone marrow not to make too many blood cells. 

Our bone marrow makes three types of blood cells; white blood cells that fight infections, red blood cells that carry oxygen and platelets which clot the blood to stop bleeding. 

When JAK2 doesn’t work right, too many red blood cells are produced. In polycythemia, other blood cells can also excessively produce.

There are also complications associated with the disease such as blood clots, enlarged spleen, open sores on the inside lining of the stomach, gout (inflammation in the joints) and other blood disorders.

Signs or symptoms of polycythemia

Many affected people don’t have any signs or symptoms but some others might show below signs:

  • Headache
  • Dizziness
  • Blurred or doubled vision
  • Unexplained weight loss
  • Reddened face
  • Excessive sweating especially at night
  • Painful swelling of joints
  • Numbness, burning or tingling sensation or weakness in your hands, feet, arms or legs

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Diagnostic procedure of polycythemia

The doctor will take a detailed review of the medical history and then perform a physical examination. He would be ordering some blood tests which include:

Complete blood count (CBC)

Your blood sample is sent to a lab where a machine counts the number of red, white blood cells and platelets. If any of these found in unusual high number, it’s a sign of polycythemia vera.

Blood smear

This test performed under a microscope can reveal other diseases which might be linked to polycythemia.

EPO Level

EPO directs your bone marrow to make blood cells and this test would reveal how much EPO hormone level you have.

Bone marrow biopsy

The biopsy of your bone marrow can tell your doctor of overproduction of blood cells. A sample of bone marrow is taken from the back of your hip bone.

Is there any cure?

It’s a chronic condition that isn’t curable. Although, by managing the disease one can live longer. Following are some of the treatment available.

Phlebotomy

In this method, some amount of blood is removed out of your veins. This reduces the number of blood cells and keeps you running. This cycle is repeated often depending upon the severity.

Low dose aspirin

These drugs reduce the risk of blood clots which in turn help reduce burning pain in hands and feets.

Hydroxyurea

An oral medication to reduce blood counts.

Ruxolitinib

In simple terms, this is medication to destroy cancer cells. This treatment is for those people who don’t respond to hydroxyurea treatment.

While the disease is not curable, one can also self-manage it by exercising moderately, avoiding tobacco, bathing in a cool shower, avoiding extreme temperatures and keeping skin moist. 

With good care, polycythemia can be managed and you can still live an active lifestyle.

Sources

1. Polycythemia vera(2013, July). read more
2. Raedler LA.,(2014, October).Diagnosis and Management of Polycythemia Vera. read more
3. Mayo Clinic Staff (2017, Feb. 8).Polycythemia vera 
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