CLINICAL PRACTICE GUIDELINE FOR POLYCYTHEMIA VERA
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ELEVATED HEMOGLOBIN AND RBC MASS
SERUM EPO IN NONPHLEBOTOMIZED PATIENTS
< OR = 5 IU/ l
> OR = 5 IU/ l
Answer if the following:
Acquired polycythemia, splenomegaly, thrombocytosis, leukocytosis
YES
NO
Polycythemia Vera
Do BM aspirate and Biopsy with cytogenetics (Optional –if available)
(Jak2 =)
Primary Familial and Congenital Polycythmia
- Screen first degree member
CYANOSIS
YES
CHD or Chronic Lung Disease
NO
YES
NO
P50
Methemoglobinemia
- Methemoglobin determination
- Evaluate Hemoglobin M
- Evaluate deficiency of Cytochrome b5 or (if available)
YES
NO
Congenital polycythemia due to actual affinity of Hemoglobin for Oxygen
Evaluate 2-3 BPG
?
?
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