Investigation and diagnosis

• FBC: tt RCC and 5 or 6 MCV and MCH (may be evidence of iron deficiency).

• Neutrophils and platelets t in PV (rare in other causes of erythrocytosis).

• NAP score: t score usually present in PV (but not diagnosticinisolation).

• Red cell mass and plasma volume: patient red cells labelled with 51Cr and re-injected; simultaneous plasma volume measurement using 131I-labelled albumin. RCM t >25% above nostic of absolute erythrocytosis. Plasma volume also t if marked splenomegaly present.

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