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- $Unique_ID{BRK04120}
- $Pretitle{}
- $Title{Polycythemia Vera}
- $Subject{Polycythemia Vera Primary Polycythemia Vaquez-Osler Disease
- Osler-Vaquez Disease Splenomegalic Polycythemia Erythremia}
- $Volume{}
- $Log{}
-
- Copyright (C) 1986, 1990 National Organization for Rare Disorders, Inc.
-
- 236:
- Polycythemia Vera
-
- ** IMPORTANT **
- It is possible the main title of the article (Polycythemia Vera) is not
- the name you expected. Please check the SYNONYMS listing to find the
- alternate names and disorder subdivisions covered by this article.
-
- Synonyms
-
- Primary Polycythemia
- Vaquez-Osler Disease
- Osler-Vaquez Disease
- Splenomegalic Polycythemia
- Erythremia
-
- General Discussion
-
- ** REMINDER **
- The information contained in the Rare Disease Database is provided for
- educational purposes only. It should not be used for diagnostic or treatment
- purposes. If you wish to obtain more information about this disorder, please
- contact your personal physician and/or the agencies listed in the "Resources"
- section of this report.
-
-
- Polycythemia Vera is a chronic proliferative disorder of the bone marrow. It
- is characterized by an increase in the number of red blood cells
- (erythrocytosis) and hemoglobin concentration in the blood.
-
- Symptoms
-
- Initial symptoms of Polycythemia Vera are fatigue, malaise, difficulty
- concentrating, headache, drowsiness, forgetfulness, and dizziness. Itchiness
- is present in 50% of patients, particularly after a hot bath. Redness of the
- skin may be seen, or patients may have normal skin color with only dusky
- redness of the mucous membranes. The retinal veins of the eyes may be dark
- red, full and tortuous. The spleen is usually palpable. Some patients do
- not have any obvious symptoms when Polycythemia is diagnosed.
-
- Causes
-
- The cause of Polycythemia Vera is not known.
-
-
- Related Disorders
-
- Leukemia is a generalized cancerous (neoplastic) disorder of the blood
- forming tissues, primarily of the white blood cell (leukocytic) type.
-
- Therapies: Standard
-
- The most common therapy for Polycythemia vera is removal of some blood from a
- vein (phlebotomy). This does not depress marrow function nor does it induce
- genetic mutation. Iron-deficiency anemia usually develops following repeated
- phlebotomy. Phlebotomy is less effective in patients with high iron
- absorption rates or greatly elevated platelet counts, and is inconvenient in
- patients with poor veins.
-
- Usually 3 to 6 phlebotomies are required to reduce the percentage of red
- blood cell volume in the blood (Hct) to less than 50%, returning the red
- blood cell number to normal. Elderly patients with advanced arteriosclerosis
- or a heart condition should have less blood removed at each phlebotomy. When
- phlebotomy is the only therapy, supplemental iron must not be prescribed
- since it tends to accelerate hemoglobin production. A low-iron diet is often
- impractical, but foods with very high iron content, such as clams, oysters,
- liver and legumes, should be avoided.
-
- Phlebotomy followed radiophosphorus (32P) therapy, produces clinical and
- hematologic remission in almost all patients. Remissions usually last 18
- months, but vary from 6 months to several years. Fewer follow-up visits are
- often required and there are usually no immediate side effects. However,
- approximately 10% of patients treated with 32P develop acute leukemia, but
- this usually occurs after more than 10 years of treatment.
-
- Chemotherapy for Polycythemia Vera is no longer advised because it
- increases the risk of developing acute leukemia.
-
- An excess of uric acid in the blood (hyperuricemia) requires treatment
- with the drug allopurinol. Acute gouty arthritis can develop and it is
- treated in the same manner as primary gout; i.e., with colchicine or
- nonsteroidal anti-inflammatory drugs for patients who are intolerant of
- colchicine. Corticosteroids can produce rapid and complete remission in some
- patients, but generally are used only when other drugs are ineffective.
-
- Therapies: Investigational
-
- The FDA allows the use of the orphan drug Anagrelide for Polycythemia Vera on
- an experimental or investigational basis. This drug is manufactured by
- Roberts Pharmaceutical Corporation, Meridian Center III, 6 Industrial Way
- West, Eatontown, NH, 07724, (908) 389-1182.
-
- This disease entry is based upon medical information available through
- June 1989. Since NORD's resources are limited, it is not possible to keep
- every entry in the Rare Disease Database completely current and accurate.
- Please check with the agencies listed in the Resources section for the most
- current information about this disorder.
-
- Resources
-
- For more information on Polycythemia Vera, please contact:
-
- National Organization for Rare Disorders (NORD)
- P.O. Box 8923
- New Fairfield, CT 06812-1783
- (203) 746-6518
-
- Myeloproliferative Research Center, Inc.
- 2220 Tiemann Ave.
- Baychester, NY 10469
- (718) 231-0270
- (800) MPD-HELP
-
- National Heart, Lung and Blood Institute
- 9000 Rockville Pike
- Bethesda, MD 20892
- (301) 496-4236
-
- References
-
- THE MERCK MANUAL 15th ed: R. Berkow, et al: eds; Merck, Sharp & Dohme
- Research Laboratories, 1987. P. 1138.
-
- CECIL TEXTBOOK OF MEDICINE, 18th ed.: James B. Wyngaarden, and Lloyd H.
- Smith, Jr., Eds.: W. B. Saunders Co., 1988. Pp. 973, 980-4.
-
-