Understanding Polycythaemia

A Comprehensive Guide to Elevated Red Blood Cell Counts

Internal Medicine

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Last updated: Mar 24, 2025

What is Polycythaemia?

Polycythaemia (also spelled polycythemia) is a condition where there is an increased concentration of red blood cells in your blood. This makes the blood thicker than normal and can affect its flow through blood vessels.

Types of Polycythaemia

Primary Polycythaemia (Polycythaemia Vera)

  • Caused by genetic mutations in bone marrow cells
  • Usually develops slowly over many years
  • More common in older adults

Secondary Polycythaemia

  • Develops as a response to other conditions
  • Can be caused by:
    • Living at high altitude
    • Chronic lung disease
    • Heart conditions
    • Smoking
    • Certain kidney tumors

Common Symptoms

  • Headaches
  • Dizziness
  • Itchy skin (especially after warm baths)
  • Reddish or purplish skin
  • Bleeding or bruising
  • Fatigue
  • Vision problems
  • Joint pain

Diagnosis

  1. Blood Tests

    • Full blood count
    • JAK2 mutation testing
    • Erythropoietin levels
  2. Bone Marrow Examination

    • May be required to confirm diagnosis
    • Helps determine type and cause

Treatment Options

Conservative Management

  • Regular blood monitoring
  • Lifestyle modifications
  • Staying hydrated

Medical Interventions

  1. Venesection (Bloodletting)

    • Regular removal of blood
    • Helps reduce blood thickness
  2. Medications

    • Hydroxyurea
    • Interferon
    • Aspirin for preventing clots

Complications if Untreated

  • Blood clots
  • Stroke
  • Heart problems
  • Enlarged spleen

Living with Polycythaemia

  • Regular medical check-ups
  • Avoid dehydration
  • Exercise moderately
  • Stop smoking
  • Report new symptoms promptly

When to Seek Medical Help

  • Chest pain
  • Shortness of breath
  • Severe headaches
  • Signs of blood clots
  • Unusual bleeding

Prevention Tips

  1. Stay well-hydrated
  2. Avoid hot baths/showers
  3. Keep active but avoid strenuous exercise
  4. Maintain healthy weight
  5. Regular medical monitoring

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