Polycythemia Vera: Symptoms, Causes, Treatment

It may be discovered incidentally on a blood count. Elevated hemoglobin or hematocrit needs investigation and alone cannot establish polycythemia vera or determine treatment.

Related reading: Another marrow disorder: chronic myeloid leukemia.

Itching after bathing, headache, dizziness, blurred vision or red burning hands and feet may occur, sometimes with abdominal fullness. Some people have no symptoms.

An acquired JAK2 gene change commonly drives excess blood-cell production. This mutation is usually not directly inherited, and not every raised red-cell count represents cancer.

Incidence increases with age, although younger adults can be affected. Clot risk depends on age, previous thrombosis and other factors; medicine selection requires individual assessment.

Assessment includes repeat blood counts, gene and erythropoietin testing and sometimes marrow biopsy. Secondary causes such as low oxygen, certain medicines and dehydration must be considered.

Treatment reduces clot risk and symptoms using prescribed phlebotomy, sometimes low-dose aspirin or medicines limiting cell production according to risk and contraindications. Do not self-start aspirin or use blood donation as treatment.

Clots, bleeding or spleen enlargement can develop. Some cases progress to marrow fibrosis or acute leukemia. Follow-up manages risks and detects important changes.

There is no established way to prevent the mutation. Smoking cessation, management of blood pressure, diabetes and cholesterol, appropriate activity and regular blood monitoring reduce vascular risk.