Apparent stress polycythemia

Apparent ('stress') polycythemia (P.e.ais.on,...1991.) is poorly understood, but the contracted plasma volume may be improved by occasional venesection if the hematocrit exceeds 0.55. Although not proven, it is thought that a change of lifestyle for patients with a contracted plasma volume may be beneficial. Therefore such patients should be firmly encouraged to stop both smoking and excessive alcohol intake. Their doctors should avoid prescribing them diuretics, using vasodilators and angiotensin-coverting enzyme inhibitors for antihypertensive and heart failure therapy. The link between stress polycythemia and vascular occlusive diseases is not well understood, and the patient's lifestyle, for example smoking habit, may be more important than a contracted plasma volume and high hematocrit in predisposing to vascular occlusive complications. It is possible that reducing high hematocrit values, for example from 0.55-0.60 to 0.50 or less, may help blood flow and organ perfusion and oxygenation.

Lancet, ii, 313-15.

G. R. Serjeant

Nomenclature

Sickiecel^trait

Sickle cell disease

Racial, distribution

Pathophysiology of sickling

Hemoglobin, levels ..a.nd...tra.nsfusion G,e,n,oty,pe,,,Y,a,ri,at,i,on

Aplasticcrisis

Pathogenesis

Acute., splenicsequestration

Pathogenesis

Septicemia Pathogenesis

Stroke

Pathogenesis

Painfulcrisis Pathogenesis

Precipitating.factors

RiskJactors

Acute.. chest.. syndrome

Pathogenesis

Pregnancy Pathogenesis Bibliography

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