Talk:Polycythemia
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[edit] JAK2
We should put a reference to the Baxter paper on this page as well. JFW | T@lk 00:34, 26 December 2005 (UTC)
- Done! I also included a reference to Levine et al. as well (full disclosure...I have worked with him before!). Andrew73 02:32, 26 December 2005 (UTC)
[edit] Name
rubra ? vera ?
Can someone explain what the 'vera' and 'rubra' in "polycythemia vera" and "polycythemia rubra vera" mean, please ? Are these Latin words ? Thanks. -- PFHLai 12:18, 2004 Jun 28 (UTC)
Polycythemia is made from 3 Greek words. Poly (many), cyto (hollow vessel or cell), & hema (blood) as it's a disease of too many blood cells. Polycythemia vera rubra is one type of this disease & vera is Latin for 'true' & rubra for 'red' since persons with this disease often show an unusually ruddy complexion. Most medical terminology is Greek or Latin derived from the Greek word.
- Also clarification, the different names are used interchangebly, as: ploycythemia rubra = polycythemia vera = polycythemia rubra vera. Gaviidae 20:44, 20 December 2006 (UTC)
[edit] Calling for an expert
This article contains errors. Primary polycythemia cannot be caused by kidney tumours - that would be secondary polycythemia. Can an expert in this area please fix up this fundamental mistake. Thanks in advance.
- --Quite right that polycythemia vera is caused by myoelodysplasia and not excess Epo. I'll make that edit, however some portions of the rest of the article probably need a touch of review in the future. Bdolcourt 14:44, 30 August 2006 (UTC)
[edit] Altitude
The page says that people who live at high altitudes can get polycythemia, and listed 4275 to 5200 meters. I've removed the elevations because I KNOW that there are a number of occurances in Leadville, Colorado, which is about 3100m. Furthermore, the top end of 5200 seems kind of arbitrary. Wenzhuan is at 5100 meters, but that doesn't mean that elevations above that are no longer 'high altitude' or that people don't live any higher than that. --Mdwyer 23:04, 18 August 2006 (UTC)
MISDIAGNOSIS…..We should add this category…
Polycythemia can be misdiagnosed for simple long term dehydration, I am a living example. Not consuming enough liquids in combination of consuming common diuretic such as; coffee, smoking and Alcohol can produce a CBC that will lead many experienced family doctors and Hematologist to a diagnosis of “Stress Polythemia”, or in my case the highest diagnosis of Polythemia Vera.
A MCV above 100 will typically indicate Alcohol abuse of some sort and the enlargement of Red Blood Cells. Most importantly, a JAK2 test is mandatory in the proper diagnosis of Polycythemia.
After three months with the rejection of Alcohol, Smoking, Coffee and the addition of massive liquids, my CBC is normal.
[edit] Improvements
I'd propose making the page primarily about polycythemia vera - the secondary causes are of little clinical significance, except insofar as they need to be distinguished from primary P. vera. It would probably be worth expanding the diagnostic algorithm for working up polycythemia and making such a distinction. There are some parts of the article that I'd like to work on in the near future - for example, P. vera can be cured (with stem cell transplantation). It's rarely done except for spent-phase disease, though. The possibility of transformation to spent-phase (myelofibrotic) disease or AML could be mentioned. Also, describing it as "non-fatal" isn't quite accurate; there's data to suggest that P. vera shortens life expectancy, and complications of P.vera (e.g. stroke, malignant transformation) can certainly be fatal. MastCell 01:58, 25 November 2006 (UTC)
[edit] Weight gain
I recently met someone who must have regular trips to the phlebotomist because she "makes too much blood." Sounded to me like polycythemia... except that they discovered she had it when she visited her doctor because of unexplained weight gain. After treatment began (solely the bloodletting) her weight vanished. This is apparently NOT a known symptom, and she had no tumors (pituitary or whatnot)... can anyone lead me to what similar diseases are out there that mimic polycythemia? One that somehow effects weight? She doesn't speak English well-enough to explain better. Gaviidae 20:31, 20 December 2006 (UTC)
- No, weight gain is not a common symptom of polycythemia vera. In general, unfortunately, Wikipedia is not a great place to get medical advice. Probably best to discuss (or have your friend discuss) with her doctor. MastCell 22:08, 20 December 2006 (UTC)
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- I have heard of a kind of a spiraling syndrome where excessive weight contributes to sleep apnea, which then contributes to polycythemia. In this case, the cause and effect are reversed, but there might still be something to it. Again, however, you would need to talk to a real doctor. --Mdwyer 00:21, 22 December 2006 (UTC)
[edit] Treatment
What about anticoagulant therapy? It can be used. [[TheAngriestPharmacist]] 04:59, 3 May 2007 (UTC)
- I did a little quick PubMed search. No trials seem to have been performed. There is little doubt that thrombotic events are an indication for long-term anticoagulation, at least until the condition is properly treated. Budd-Chiari syndrome, for instance, is generally treated with indefinite anticoagulation. JFW | T@lk 14:03, 3 May 2007 (UTC)
[edit] Target hematocrit
I removed the sentence about phlebotomy being reserved for hematocrits of >55-60 or demonstrated thrombotic events. In p. vera, phlebotomy is usually performed pre-emptively to bring the Hct down below 45 (for men) or below 42 (for women) - see PMID 11830459, for example. However, you're right about secondary polycythemia - it's much more of a gray area, and most people wouldn't phlebotomize unless the hematocrit was extreme or there were demonstrated thrombotic events (as the biology of secondary polycythemia is quite different from that of p vera or other myeloproliferative disorders). This is more of a practice-point/expert opinion thing, so it's hard to find a good reference for. MastCell Talk 16:43, 3 May 2007 (UTC)
[edit] JAK2 mutation and treatment for primary polycythemia
Will someone edit the article to include information regarding the JAK 2 mutation? Until recently, there has been no actual treatment because the mutation that causes polycythemia had not been identified. There is a clinical trial in Phase I going on at UCLA Medical Center and a safety study in progress at UCSF and a few other places in the United States. The information can be found at www.clinicaltrials.gov. The medication being studied in the trial-XL019-represents the first treatment for the disease rather than symptom management. My experience with primary polycythemia has involved polypharmacy (including hydorxyurea, anegrelide, plavix, and asprin) after a splenectomy and the phlebotomies became ineffective. --SJRN1 (talk) 22:34, 20 February 2008 (UTC)
