{"id":4317,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/polycythemia\/"},"modified":"2023-08-31T14:26:22","modified_gmt":"2023-08-31T13:26:22","slug":"polycythemia","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/haematology\/polycythemia\/","title":{"rendered":"Polycythemia (Erythrocytosis)"},"content":{"rendered":"\n<title>Polycythemia<\/title>\n\n\n\n<h4 class=\"wp-block-heading\">Definition&nbsp; <\/h4>\n\n\n\n<p>Usually associate<span>d with raised haemoglobin concentration or raised haematocrit.&nbsp; <\/span><\/p>\n\n\n\n<p><span>Polycythemia may be spurious (diuretics, dehydration, alcohol etc) or secondary (eg associated with hypoxia).\u00a0 Primary myeloproliferative neoplasms (MPNs) may be associated with leucocytosis and thrombocytosis also.\u00a0 <\/span><\/p>\n\n\n\n<p><strong>C.M &amp; L.W 31-07-23<\/strong><br><\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\">Who to refer:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Patients with a persistently raised venous haematocrit (Hct) for at least 2 months should be investigated.<\/li>\n\n\n\n<li>Please refer males with Hct &gt; 0.52 and females with Hct &gt; 0.48.<\/li>\n\n\n\n<li>If Hct doesn\u2019t meet above values but low MCV with disproportionately high Hb\/Hct, check serum ferritin.&nbsp; If ferritin low, this may represent an iron deficient polycythaemia vera, hence referral appropriate.<\/li>\n<\/ul>\n\n\n\n<p><strong>Urgent investigation of polycythaemia <\/strong>is required If there is a history of arterial thrombosis, or evidence of recent acute occlusive events.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Who not to refer:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Patients who do not fulfil the above criteria.<\/li>\n\n\n\n<li>If severe hypoxia\/lung disease, initial referral to respiratory physicians more appropriate.<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">How to refer:<\/h4>\n\n\n\n<p>SCI Gateway to the Department of Haematology WGH or St John\u2019s Hospital.<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h3 class=\"wp-block-heading\">Primary care investigations<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Serial FBCs at least 1 month apart.<\/li>\n\n\n\n<li>Serum ferritin.<\/li>\n\n\n\n<li>Pulse oximetry<\/li>\n\n\n\n<li>General evaluation for any possible contributory cause e.g. CXR, SpO<sub>2<\/sub>&nbsp;if hypoxic pulmonary disease suspected.<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\"><\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Polycythemia Definition&nbsp; Usually associated with raised haemoglobin concentration or raised haematocrit.&nbsp; Polycythemia may be spurious (diuretics, dehydration, alcohol etc) or secondary (eg associated with hypoxia).&nbsp; Primary myeloproliferative neoplasms (MPNs) may be associated with leucocytosis and thrombocytosis also.&nbsp; C.M &amp; L.W 31-07-23<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":3981,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[271],"class_list":["post-4317","page","type-page","status-publish","hentry","category-polycythemia"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/haematology\/polycythemia\/\" rel=\"tag\">Polycythemia<\/a>","rttpg_excerpt":"Polycythemia Definition&nbsp; Usually associated with raised haemoglobin concentration or raised haematocrit.&nbsp; Polycythemia may be spurious (diuretics, dehydration, alcohol etc) or secondary (eg associated with hypoxia).&nbsp; Primary myeloproliferative neoplasms (MPNs) may be associated with leucocytosis and thrombocytosis also.&nbsp; C.M &amp; L.W 31-07-23","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4317","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=4317"}],"version-history":[{"count":7,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4317\/revisions"}],"predecessor-version":[{"id":16143,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4317\/revisions\/16143"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3981"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=4317"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=4317"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}