Secondary Polycythemia

Secondary polycythemia is RBC-mass elevation caused by increased erythropoietin drive. It is divided into: (1) appropriate secondary polycythemia from chronic hypoxemia - high altitude, smoking, chronic lung disease, cyanotic heart disease, obstructive sleep apnea; (2) inappropriate secondary polycythemia from EPO-secreting tumors (renal-cell carcinoma, hepatocellular carcinoma, cerebellar hemangioblastoma, uterine myoma) or renal disease (hydronephrosis, renal artery stenosis). It is distinguished from polycythemia vera by normal WBC/platelets, low/normal leukocyte alkaline phosphatase, absent JAK2V617F, and elevated EPO.

Common Symptoms

Plethora; ruddy face; headache; dizziness; hypertension; hyperviscosity symptoms; underlying disease signs

Causes and Pathogenesis

Chronic hypoxemia or ectopic EPO overproduction drives erythropoiesis, increasing RBC mass and viscosity.

Treatment

Treat underlying cause (smoking cessation, lung/cardiac disease, tumor resection); phlebotomy if symptomatic; oxygen therapy for hypoxemia

Preventive Measures

Quit smoking; treat chronic lung/heart disease; evaluate for EPO-secreting tumors; avoid dehydration.

Department to Visit

It is recommended to visit the Hematology department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.