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Leukemia: Polycythemia – White Blood Cell Pathology

by Carlo Raj, MD
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    Our topic here is polycythemia. What does it mean to you? Polycythemia means excess increase in RBC mass. Only? Well, it depends. I’m going to walk you through a very important table coming up. Primary polycythemia. It’s absolutely independent of erythropoietin. Independent. That means what? That means that you would find the tumor, the neoplasia, within the bone marrow. Welcome to polycythemia vera. So, what do you think my erythropoietin level will be in a patient that has primary polycythemia? Decreased, decreased, decreased. It shuts erythropoietin levels down. That must be understood. Next, if you have a primary neoplasm in the bone marrow, it has a choice of really producing anything it wants. It can produce your, let’s say your RBC, it can produce a lot of platelets but for thrombosis. It can produce a heck of a lot of basophils, it can. And if it does, now your patient takes a hot bath and feels, “Hey, doc, I feel itchy.” There’s itchiness taking place after a hot bath. Pruritus after hot bath, ladies and gentlemen, that is going to be polycythemia vera. Why? Due to excess basophilia. Primary. Secondary. Secondary means any cause that caused an increase in EPO. Thus, specifically increase in RBC mass. For example, what if you had a patient that was in high altitude? Hypoxia. Maybe about three weeks later, that hypoxia is going to trigger the kidney through this erythropoietin. Erythropoietin works in the bone marrow to increase RBC mass. Welcome to secondary polycythemia. Hypoxia, cause number one. Cause number two, maybe your patient had an erythropoietin cancer. What do I mean? An erythropoietin paraneoplastic cancer, such as RCC or maybe HCC. So renal cell carcinoma, that might be producing too much erythropoietin will cause what kind of polycythemia? Secondary polycythemia. Or you can...

    About the Lecture

    The lecture Leukemia: Polycythemia – White Blood Cell Pathology by Carlo Raj, MD is from the course Leukemia – White Blood Cell Pathology (WBC).


    Included Quiz Questions

    1. Polycythemia vera
    2. High altitude
    3. Blood doping
    4. Lung disease
    5. Renal cell carcinoma
    1. Polycythemia vera
    2. Acute myeloid leukemia
    3. Hairy cell leukemia
    4. Acute lymphoblastic leukemia
    5. Renal cell carcinoma
    1. Myeloproliferative disease
    2. Adrenal adenoma
    3. Renal cell carcinoma
    4. Pheochromocytoma
    5. Von hippel-lindau disease
    1. Thrombocytopenia
    2. Strokes
    3. Pulmonary embolism
    4. Heart attacks
    5. Hyperviscosity syndrome
    1. Relative polycythemia
    2. Chuvash polycythemia
    3. Primary polycythemia
    4. Physiologic polycythemia
    5. Absolute polycythemia

    Author of lecture Leukemia: Polycythemia – White Blood Cell Pathology

     Carlo Raj, MD

    Carlo Raj, MD


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