Polycythemia differential diagnosis: Difference between revisions
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==Overview== | ==Overview== | ||
==Differential Diagnosis== | ==Differential Diagnosis of Polycythemia== | ||
Polycythemia must be differentiated from a variety of other conditions.<ref name="pmid25611051">{{cite journal| author=Tefferi A, Barbui T| title=Polycythemia vera and essential thrombocythemia: 2015 update on diagnosis, risk-stratification and management. | journal=Am J Hematol | year= 2015 | volume= 90 | issue= 2 | pages= 162-73 | pmid=25611051 | doi=10.1002/ajh.23895 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25611051 }} </ref><ref name="pmid16879015">{{cite journal| author=Sanchez S, Ewton A| title=Essential thrombocythemia: a review of diagnostic and pathologic features. | journal=Arch Pathol Lab Med | year= 2006 | volume= 130 | issue= 8 | pages= 1144-50 | pmid=16879015 | doi=10.1043/1543-2165(2006)130[1144:ET]2.0.CO;2 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16879015 }} </ref><ref name="pmid24729196">{{cite journal| author=Jabbour E, Kantarjian H| title=Chronic myeloid leukemia: 2014 update on diagnosis, monitoring, and management. | journal=Am J Hematol | year= 2014 | volume= 89 | issue= 5 | pages= 547-56 | pmid=24729196 | doi=10.1002/ajh.23691 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24729196 }} </ref> | Polycythemia must be differentiated from a variety of other conditions.<ref name="pmid25611051">{{cite journal| author=Tefferi A, Barbui T| title=Polycythemia vera and essential thrombocythemia: 2015 update on diagnosis, risk-stratification and management. | journal=Am J Hematol | year= 2015 | volume= 90 | issue= 2 | pages= 162-73 | pmid=25611051 | doi=10.1002/ajh.23895 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25611051 }} </ref><ref name="pmid16879015">{{cite journal| author=Sanchez S, Ewton A| title=Essential thrombocythemia: a review of diagnostic and pathologic features. | journal=Arch Pathol Lab Med | year= 2006 | volume= 130 | issue= 8 | pages= 1144-50 | pmid=16879015 | doi=10.1043/1543-2165(2006)130[1144:ET]2.0.CO;2 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16879015 }} </ref><ref name="pmid24729196">{{cite journal| author=Jabbour E, Kantarjian H| title=Chronic myeloid leukemia: 2014 update on diagnosis, monitoring, and management. | journal=Am J Hematol | year= 2014 | volume= 89 | issue= 5 | pages= 547-56 | pmid=24729196 | doi=10.1002/ajh.23691 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24729196 }} </ref> | ||
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! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Associated findings | ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Associated findings | ||
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==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} |
Revision as of 15:19, 21 August 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]
Overview
Differential Diagnosis of Polycythemia
Polycythemia must be differentiated from a variety of other conditions.[1][2][3]
Disease | Mutation | Etiology | Clinical manifestations | Laboratory findings | Treatment | Associated findings | |||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Symptoms | Signs | CBC | Erythropoietin level | PBS | |||||||||||||||||
JAK2 mutation | CALR mutation | Fatigue | Headache | Bleeding | Pain | Other symptoms | Appearance | Fever | Tenderness | Splenomegaly | Other signs | Hb | RBC | WBC | Plt | ||||||
Polycythemia vera (PV) | > 95% | Autonomous erythrocyte production | + | - |
|
Ruddy face | - | - | + | NA | ↑ | ↑ RBC mass | Nl to ↑ | Nl to ↑ | |||||||
Essential thrombocythemia (ET) | 50% | +/- |
|
+ | + (paradoxical) |
|
+ | Bruises | ↑ (dysfunctional platelets) | ||||||||||||
Chronic myeloid leukemia (CML) | - | - |
|
+ | + | + | Abdominal pain | + | + | ↑ | ↑ | ↑ | ↑ | Elevated metamyelocytes and other white blood cells at various stages of maturation |
| ||||||
Primary myelofibrosis (PMF) |
|
+ | + | Abdominal pain |
|
Pallor | + | ↓ | ↓ | ↓ | ↓ |
| |||||||||
Secondary polycythemia due to chronic hypoxia | - | - |
|
+ | + | - | Depends on etiology | Cyanosis | - | ↑ | ↑ | Nl | Nl | ↑ |
|
| |||||
Secondary polycythemia due to erythropoietin producing tumor | - | - |
|
+ | - | - | Depends on etiology | Depends on etiology | Chronically ill | +/- | +/- | - | ↑/↓ | ↑/↓ | Nl | ↑ | ↑ |
|
| ||
Disease | JAK2 mutation | CALR mutation | Etiology | Fatigue | Headache | Bleeding | Pain | Other symptoms | Appearance | Fever | Tenderness | Splenomegaly | Other signs | Hb | RBC | WBC | Plt | Erythropoietin level | PBS | Treatment | Associated findings |
References
- ↑ Tefferi A, Barbui T (2015). "Polycythemia vera and essential thrombocythemia: 2015 update on diagnosis, risk-stratification and management". Am J Hematol. 90 (2): 162–73. doi:10.1002/ajh.23895. PMID 25611051.
- ↑ Sanchez S, Ewton A (2006). "Essential thrombocythemia: a review of diagnostic and pathologic features". Arch Pathol Lab Med. 130 (8): 1144–50. doi:10.1043/1543-2165(2006)130[1144:ET]2.0.CO;2. PMID 16879015.
- ↑ Jabbour E, Kantarjian H (2014). "Chronic myeloid leukemia: 2014 update on diagnosis, monitoring, and management". Am J Hematol. 89 (5): 547–56. doi:10.1002/ajh.23691. PMID 24729196.