Polycythemia vera laboratory tests: Difference between revisions

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{{Polycythemia vera}}
{{Polycythemia vera}}
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==Overview==
==Overview==
Laboratory findings associated with the diagnosis of polycythemia vera include [[erythrocytosis]], [[leukocytosis]], and [[thrombocytosis]]. The most sensitive test for polycythemia vera is JAK2 V617F mutation testing in the peripheral blood. A specific finding in patients with polycythemia vera is low [[erythropoietin]] level.


==Laboratory Findings==
==Laboratory Findings==
Patients with polycythemia vera may often be [[asymptomatic]]. The diagnosis is often suspected on the basis of laboratory tests. Common findings include an elevated hemoglobin level or [[hematocrit]], reflecting the increased number of red blood cells; the [[platelet count]] or [[white blood cell count]] may also be increased. Because polycythemia vera results from an essential increase in erythrocyte production, patients have a low  erythropoietin (EPO) level.
Laboratory findings associated with polycythemia vera include:<ref name="pmid17178662">{{cite journal| author=Mazzotta S, Guerranti R, Gozzetti A, Bucalossi A, Bocchia M, Sammassimo S et al.| title=Increased serum lactate dehydrogenase isoenzymes in Ph-negative chronic myeloproliferative diseases: a metabolic adaptation? | journal=Hematology | year= 2006 | volume= 11 | issue= 4 | pages= 239-44 | pmid=17178662 | doi=10.1080/10245330600774835 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17178662  }} </ref><ref name="pmid5947579">{{cite journal| author=Denman M, Szur L, Ansell BM| title=Hyperuricaemia in polycythaemia vera. | journal=Ann Rheum Dis | year= 1966 | volume= 25 | issue= 4 | pages= 340-4 | pmid=5947579 | doi= | pmc=PMC2453349 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=5947579  }} </ref><ref name="pmid23606974">{{cite journal| author=Murakami J, Shimizu Y| title=Hepatic manifestations in hematological disorders. | journal=Int J Hepatol | year= 2013 | volume= 2013 | issue=  | pages= 484903 | pmid=23606974 | doi=10.1155/2013/484903 | pmc=PMC3626309 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23606974  }} </ref><ref name="pmid9299851">{{cite journal| author=Remacha AF, Montserrat I, Santamaria A, Oliver A, Barceló MJ, Parellada M| title=Serum erythropoietin in the diagnosis of polycythemia vera. A follow-up study. | journal=Haematologica | year= 1997 | volume= 82 | issue= 4 | pages= 406-10 | pmid=9299851 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9299851  }} </ref><ref name="pmid26324368">{{cite journal |vauthors=Stein BL, Oh ST, Berenzon D, Hobbs GS, Kremyanskaya M, Rampal RK, Abboud CN, Adler K, Heaney ML, Jabbour EJ, Komrokji RS, Moliterno AR, Ritchie EK, Rice L, Mascarenhas J, Hoffman R |title=Polycythemia Vera: An Appraisal of the Biology and Management 10 Years After the Discovery of JAK2 V617F |journal=J. Clin. Oncol. |volume=33 |issue=33 |pages=3953–60 |date=November 2015 |pmid=26324368 |pmc=4979103 |doi=10.1200/JCO.2015.61.6474 |url=}}</ref><ref name="pmid27069254">{{cite journal| author=Arber DA, Orazi A, Hasserjian R, Thiele J, Borowitz MJ, Le Beau MM et al.| title=The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. | journal=Blood | year= 2016 | volume= 127 | issue= 20 | pages= 2391-405 | pmid=27069254 | doi=10.1182/blood-2016-03-643544 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27069254  }} </ref>
 
*[[Complete blood count]]
In primary polycythemia, there may be 8 to 9 million and occasionally 11 million erythrocytes per cubic millimeter of blood (a normal range for adults is 4-6), and the [[hematocrit]] may be as high as 70 to 80%. In addition, the total blood volume sometimes increases to as much as twice normal. The entire vascular system can become markedly engorged with blood, and circulation times for blood throughout the body can increase up to twice the normal value. The increased numbers of [[erythrocyte]]s can cause the [[viscosity]] of the blood to increase as much as five times normal. Capillaries can become plugged by the very viscous blood, and the flow of blood through the vessels tends to be extremely sluggish.
:*[[Erythrocytosis]]
:*Increased [[hemoglobin]]
:*[[Thrombocytosis]]
:*[[Leukocytosis]]
:*Increased [[basophil]]s and [[eosinophils]]
*The following blood levels may be elevated in blood chemistry (non specific):
:*Blood urea nitrogen ([[BUN]])
:*[[Creatinine]]
:*[[Phosphate]]
:*[[Lactate dehydrogenase]] (LDH)
:*[[Alanine aminotransferase]] (ALT)
:*[[Aspartate transaminase]] (AST)
:*[[Uric acid]]
*Peripheral blood mutational testing
:*[[JAK2]] V617F mutation or [[Janus kinase|JAK2]] exon 12 mutation
*Bleeding and clotting factor
:*[[Prothrombin time|Elevation of prothrombin time]] (PT) or [[international normalized ratio]] (INR)
:*[[Partial thromboplastin time|Elevation of partial thromboplastin time]] (PTT)
*[[Erythropoietin]] (EPO)
:*It is usually low in polycythemia vera but can be normal in about 20% of patients.  
:*It is usually high in secondary polycythemia vera.
*[[Bone marrow biopsy]]
:*Elevation of [[white blood cells]], [[red blood cells]], and [[platelets]]


==References==
==References==
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Latest revision as of 03:11, 14 September 2019


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Overview

Laboratory findings associated with the diagnosis of polycythemia vera include erythrocytosis, leukocytosis, and thrombocytosis. The most sensitive test for polycythemia vera is JAK2 V617F mutation testing in the peripheral blood. A specific finding in patients with polycythemia vera is low erythropoietin level.

Laboratory Findings

Laboratory findings associated with polycythemia vera include:[1][2][3][4][5][6]

  • The following blood levels may be elevated in blood chemistry (non specific):
  • Peripheral blood mutational testing
  • JAK2 V617F mutation or JAK2 exon 12 mutation
  • Bleeding and clotting factor
  • It is usually low in polycythemia vera but can be normal in about 20% of patients.
  • It is usually high in secondary polycythemia vera.

References

  1. ↑ Mazzotta S, Guerranti R, Gozzetti A, Bucalossi A, Bocchia M, Sammassimo S; et al. (2006). "Increased serum lactate dehydrogenase isoenzymes in Ph-negative chronic myeloproliferative diseases: a metabolic adaptation?". Hematology. 11 (4): 239–44. doi:10.1080/10245330600774835. PMID 17178662.
  2. ↑ Denman M, Szur L, Ansell BM (1966). "Hyperuricaemia in polycythaemia vera". Ann Rheum Dis. 25 (4): 340–4. PMC 2453349. PMID 5947579.
  3. ↑ Murakami J, Shimizu Y (2013). "Hepatic manifestations in hematological disorders". Int J Hepatol. 2013: 484903. doi:10.1155/2013/484903. PMC 3626309. PMID 23606974.
  4. ↑ Remacha AF, Montserrat I, Santamaria A, Oliver A, Barceló MJ, Parellada M (1997). "Serum erythropoietin in the diagnosis of polycythemia vera. A follow-up study". Haematologica. 82 (4): 406–10. PMID 9299851.
  5. ↑ Stein BL, Oh ST, Berenzon D, Hobbs GS, Kremyanskaya M, Rampal RK, Abboud CN, Adler K, Heaney ML, Jabbour EJ, Komrokji RS, Moliterno AR, Ritchie EK, Rice L, Mascarenhas J, Hoffman R (November 2015). "Polycythemia Vera: An Appraisal of the Biology and Management 10 Years After the Discovery of JAK2 V617F". J. Clin. Oncol. 33 (33): 3953–60. doi:10.1200/JCO.2015.61.6474. PMC 4979103. PMID 26324368.
  6. ↑ Arber DA, Orazi A, Hasserjian R, Thiele J, Borowitz MJ, Le Beau MM; et al. (2016). "The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia". Blood. 127 (20): 2391–405. doi:10.1182/blood-2016-03-643544. PMID 27069254.

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