Clinical Case

1. POLYCYTHEMIA

2. 38 year old patient has been admitted for raised
Hb,RBC .
Currently the patient is asymptomatic.

3. ON EXAMINATION
Jaundice: Nil
Anemic:Nil
LN:Nil
Cyanosis:Nil
Clubbing:Nil
Oedema:Nil
Dehydration:Nil
VITALS:
P:80/min
BP:150/100mmHg
R/R:20/min
T:36.6c
Wt:102kg

4. CHEST: B/l clear air entry
CVS:S1.S2.M0
P/A:Soft nontender,no organomegaly

5. MEDICAL h/o:HTN+,no DM,PTB,Hepatitis
SURGICAL h/o:non significant
ALLERGIC h/O:non significant
PERSONAL h/o:Smoker X 10 years,alcoholic+

6. INVESTIGATIONS
COMPLETE BLOOD COUNT:
WBC:10.44X10*9/L(N=62.5%),L(29.3%),
RBC:6.56X10*12/L,HB:203g/L,HCT:60.2%
PLT:193X10*9/L
Random Blood Sugar:6.71mmol/L
RENAL FUNCTION TEST:
Urea:4.7mmol/L,Cr:78umol/L
Na:140mmol/L,K:3.78mmol/L

12. DIAGNOSIS
 POLYCYTHEMIA
 HYPERTENSION

13. INTRODUCTION
 Polycythemia (also known as polycythaemia or
polyglobulia) is a disease state in which the
proportion of blood volume that is occupied by red
blood cells increases.
 Blood volume proportion can be measured by
HCT levels.

17.  An increase in the number of red blood cells
 Elevated hematocrit measurement
 Elevated levels of hemoglobin
 Very low levels of erythropoietin

19. TREATMENT
Phlebotomy
Low dose of ASPIRIN
Medication to decrease blood cells:
Hydroxyurea,IFN@

20. COMPLICATIONS
Blood Clots:Leading to risk of CVA,MI
Massive Splenomegaly
Itching of Skin
Other Blood Disorder:Myelofibrosis,MDS,Acute Leukemia

21. DEBATABLE POINTS
Why not to use Hydroxyurea ,IFN@?
Is it worthy sending serum EPO?
Random Blood Sugar is high,Patient is obese
to send Fasting Blood Sugar is a must?
 While using ASPIRIN,PPI should be used to protect
patient from Peptic Ulcer,UGI bleeding?

23. Reference
www.mayoclinic.org
http://o.quizlet.com/i/ETrGKdDiTFnjmbW5FpU9xg_m.jpg
http://photos1.blogger.com/blogger/6305/3126/320/MRCP_polycythaemia.png
http://www.bloodjournal.org/content/bloodjournal/120/2/275/F3.large.jpg?sso-
checked=true

24. THANK YOU