Renal and Liver Function Tests and Serum Uric Acid

Any renal impairment may suggest renal causes of secondary erythrocytosis. Cirrhosis and excessive alcohol consumption causing impaired liver function may result in an absolute ery-throcytosis due to associated hypoxemia, diminished Epo

Table 9-3. Proposed Modified Criteria for the Diagnosis of Polycythemia Veraa

A1 Raised red cell mass (>25% above normal predicted value) A2 Absence of cause of secondary polycythemia A3 Palpable splenomegaly

A4 Acquired cytogenetic abnormality

B1 Thrombocytosis (platelet count > 400 x 109/L)

B2 Neutrophil leukocytosis

(neutrophil count > 10 x 109/L) B3 Splenomegaly demonstrated on isotope/ultrasound scanning B4 Characteristic BFU-E growth or reduced serum erythropoietin

Abbreviation: BFU-E, Burst-forming unit erythroid. a A1+A2+ A3 or A4 establishes PV. A1+A2+ two of B criteria establishes PV.

(From Pearson and Messinezy,92 with permission.)

Table 9-4. Suggested Stages of Investigation in Patients with a Demonstrated Absolute Erythrocytosisa

Stage 1

Stage 2

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