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Stress Polycythemia
Erythrocytosis Stress

Presentation

The documents contained in this web site are presented for information purposes only. The material is in no way intended to replace professional medical care by a qualified specialist and should not be used as a basis for diagnosis or treatment. [orpha.net]

Figure 1: On presentation our patient had erythema, swelling, and perspiration of the soles of her feet. [clinmedjournals.org]

One half of the patients studied in the present series, and 47% of those previously reported had severe cardiovascular disease; 71% of the latter patients also had arterial hypertension. [jamanetwork.com]

Case presentation A 41-year-old woman presented to our department with cyanosis, dyspnea and plethora. The patient suffered from chronic kidney disease (CKD) and ToF, for which she was treated palliatively in the past. [bmcmedgenet.biomedcentral.com]

Table 12-1 presents an etiologic framework based on different mechanisms responsible for the expansion of the red cell mass. [basicmedicalkey.com]

Entire Body System

  • Fatigue

    We ask about general symptoms (anxious mood, depressed mood, fatigue, pain, and stress) regardless of condition. Last updated: January 31, 2019 [patientslikeme.com]

    Causes of spurious polycythemia include: burns diarrhea hemoconcentration (higher-than-normal concentration of cells and solids in the blood, usually due to becoming dehydrated or taking diuretics ) stress Weakness, headaches, and fatigue are usually [encyclopedia.com]

    Fatigue and headache were common, and syncopal attacks occurred in four patients. [nejm.org]

    On this subject I am 24 and having severe concentration problems fatigue and memory issues so bad currently right now that I cant even enjoy life to its fullest extent dating friends etc. [curezone.org]

    See also altitude sickness, erythrocytosis. observations Clinical manifestations for polycythemia include weakness and fatigue; headache and vertigo; visual disturbances (scotoma, double or blurred vision); dyspnea; nosebleeds; night sweats; and epigastric [medical-dictionary.thefreedictionary.com]

Respiratoric

  • Productive Cough

    Her illness began with mild upper airway symptoms (coryza, sore throat), accompanied by myalgias, arthralgias, malaise, fatigue, and anorexia followed by an intermittent non-productive cough and exacerbation of her migraine headaches. [clinmedjournals.org]

Cardiovascular

  • Hypertension

    Our patient had four risk factors for Gaisbock's syndrome - hypertension, diuretic therapy, physical and emotional stress, and obesity; of these, hypertension (particularly diastolic hypertension) appears to be the most significant contributor to the [clinmedjournals.org]

    male sex, smoking and diuretic therapy; of these, hypertension appears to be the most significant contributor to the polycythemia of Gaisbock’s syndrome.2 In this regard, Emamian and associates studied 9,808 individuals with essential hypertension and [japi.org]

    This patient had four risk factors for Gaisbock's syndrome: hypertension, male sex, smoking, and diuretic treatment; of these, hypertension appears to be the most important contributor to Gaisbock's syndrome polycythemia. [medicaldialogues.in]

    One half of the patients studied in the present series, and 47% of those previously reported had severe cardiovascular disease; 71% of the latter patients also had arterial hypertension. [jamanetwork.com]

    […] pol·y·cy·the·mi·a hy·per·to·n'i·ca polycythemia associated with hypertension, but without splenomegaly. [medical-dictionary.thefreedictionary.com]

  • Diastolic Hypertension

    hypertension of varying severity. [jamanetwork.com]

    Our patient had four risk factors for Gaisbock's syndrome - hypertension, diuretic therapy, physical and emotional stress, and obesity; of these, hypertension (particularly diastolic hypertension) appears to be the most significant contributor to the [clinmedjournals.org]

    hypertension (authors: “this is a lower frequency of hypertension than that found by others in similar patients.”) [thebloodproject.com]

Skin

  • Flushing

    She also noted the occurrence of flushing of her face and swelling and flushing of the soles of her feet. Her past medical history was notable for hypertension, a multinodular thyroid, and mild IgM deficiency. [clinmedjournals.org]

    The elevated blood cell mass results in hyperviscosity, which may manifest with fatigue, facial flushing, pruritus, erythromelalgia, headaches, dizziness, and, in severe cases, thromboembolic events (e.g., stroke, Budd-Chiari syndrome). [www-amboss-com.db.rsu.lv]

    Now my symptoms as you know were Severe Fatigue, Severe Facial Flushing, Very fast heart rate, confusion and drowsiness, Memory Problems, Short term memory loss. ------------------------------------------------------- Verifiable sources: (I will put quotes [curezone.org]

    Weakness, fatigue, headache, blood clotting, vertigo, tinnitus, irritability, dyspnea, visual disturbances, flushing of face, redness, or ruddy cyanosis, pruritus, ecchymosis, hypertension, epigastric distress, weight loss, and pain in joints or extremities [medical-dictionary.thefreedictionary.com]

  • Palmar Erythema

    He had glossitis, palmar erythema and his tongue was dark red. He had no lymphadenopathy, and the examination of his heart, lungs and abdomen was unremarkable. His skin turgor was normal. [japi.org]

Psychiatrical

  • Chronic Anxiety

    Behavioral/emotional stress and chronic anxiety have been shown to cause changes in hemorheologic measures, possibly due to increases in catecholamines and blood pressure [18]. [journals.plos.org]

Face, Head & Neck

  • Malar Rash

    rash Discoid rash With pregnancy there is an increased incidence of pre-eclampsia, uterine infection, SAb, prematurity, IUGR, congenital heart bloack and endomyocardial fibrosis. [pathologyexpert.com]

Urogenital

  • Renal Artery Bruit

    Renal arterial bruits on examination of the abdomen, flanks and back provide an important sign of renovascular hypertension. [thoracickey.com]

Neurologic

  • Headache

    One visible symptom of polycythemia vera are headaches, according to this research from the National Institutes of Health. By reducing blood flow to the brain, painful headaches can become quite common. [activebeat.com]

    With further increases, the patient may develop central nervous system symptoms, such as forgetfulness, lethargy, or headache, and may have signs of excess cardiac preload, such as distended neck veins and hepatic congestion. [accessmedicine.mhmedical.com]

    These patients had an overweight, stocky habitus, a plethoric appearance with suffusion of the eyes, tense and anxious personalities, a cigarette smoking habit, vascular disease, headaches, and facial rubor. [x-mol.com]

    This may cause sluggishness, irritability, headache, dizziness, fainting, disturbances of sensation in the hands and feet, and a feeling of fullness in the head. There may be episodes of acute pain as spontaneous clots occur in the blood vessels. [medical-dictionary.thefreedictionary.com]

    Causes of spurious polycythemia include: burns diarrhea hemoconcentration (higher-than-normal concentration of cells and solids in the blood, usually due to becoming dehydrated or taking diuretics ) stress Weakness, headaches, and fatigue are usually [encyclopedia.com]

  • Dizziness

    He noted that plethoric people may have an increased quantity of "globules" in the blood and that some of these persons have peculiar symptoms including vertigo and dizziness. But not all plethoric persons have elevated concentrations of hemoglobin. [jamanetwork.com]

    When left untreated, these headaches can intensify, leading to dizziness, lightheadedness, and overall feelings of weakness. If these feelings become a part of your daily routine, be sure to talk to your doctor. ADVERTISEMENT [activebeat.com]

    The elevated blood cell mass results in hyperviscosity, which may manifest with fatigue, facial flushing, pruritus, erythromelalgia, headaches, dizziness, and, in severe cases, thromboembolic events (e.g., stroke, Budd-Chiari syndrome). [www-amboss-com.db.rsu.lv]

    These include: headaches blurred vision red skin – particularly in the face, hands and feet tiredness high blood pressure dizziness discomfort in the tummy confusion bleeding problems – such as nosebleeds and bruising gout – which can cause joint pain [nhs.uk]

  • Lethargy

    With further increases, the patient may develop central nervous system symptoms, such as forgetfulness, lethargy, or headache, and may have signs of excess cardiac preload, such as distended neck veins and hepatic congestion. [accessmedicine.mhmedical.com]

    These included “feeding problems” (21.8%), plethora (20.0%), lethargy (14.5%), cyanosis (14.5%), respiratory distress (9.1%), jitteriness (7.3%), and hypotonia (7.3%). Other findings included hypoglycemia (40.0%) and hyperbilirubinemia (21.8%). [medtextfree.wordpress.com]

  • Agitation

    She is agitated and complains of substernal chest pain. Chest exam reveals few bibasilar crackles. Cardiac, abdominal, and extremity exams are normal except for her surgical wounds, which seem to be healing well. [drsami.com]

Workup

A workup revealed no evidence of polycythemia rubra vera or a secondary cause of his polycythemia (his erythropoietin level was normal, he had no splenomegaly, and a test for JAK2 v617F mutation was negative). [plexusmd.com]

The initial workup of erythrocytosis is dependant on the probability of polycythemia vera as the underlying cause. A serum erythropoietin level is usually the first step. [thebigl.co]

A workup revealed no evidence of polycythemia rubra vera or a secondary cause of her polycythemia (her erythropoietin level was normal, she had no splenomegaly, and a test for JAK2 v617F mutation was negative). [clinmedjournals.org]

See Presentation and Workup. To the extent that the increased RBCs alleviate tissue hypoxia, secondary polycythemia may in fact be beneficial. [emedicine.medscape.com]

Other Test Results

  • Decreased Plasma Volume

    — The "Gaisböck Syndrome," although considered by some as a "nonentity," has the specific hematologic findings of an apparent polycythemia, a normal circulating red blood cell (RBC) mass, and a decreased plasma volume. [jamanetwork.com]

    Since the Hct is a ratio between the number of circulating RBCs per unit volume of whole blood, an elevated Hct may be caused by a decreased plasma volume. Thus, true erythrocytosis is based on demonstrating an increased RBC mass. [163.178.103.176]

    Nervous stress leads to hemoconcentration by some unknown mechanism, possibly by temporarily decreasing circulating plasma volume or by vascular redistribution of erythrocytes. high normal RBC mass and low normal plasma volume. [doctor-clinic.org]

Treatment

The team concluded that treatment should involve strict hypertension control, avoidance of diuretic treatment, smoking cessation, and, in obese patients, the implementation of a strong weight reduction plan. [medicaldialogues.in]

The material is in no way intended to replace professional medical care by a qualified specialist and should not be used as a basis for diagnosis or treatment. [orpha.net]

The information in this site is provided only as a resource for PG entrance aspirants, and is not to be used for any diagnostic or treatment purposes. [pgblazer.com]

What are the current treatment approaches for patients with polycythemia vera and essential thrombocythemia?. [www-amboss-com.db.rsu.lv]

Prognosis

Prognosis Prognosis is impaired by the development of cardiovascular complications. The documents contained in this web site are presented for information purposes only. [orpha.net]

Survival and prognosis among 1545 patients with contemporary polycythemia vera: an international study. Leukemia. 2013;27(9):1874-1881. doi: 10.1038/leu.2013.163. Epub 2013 Jun 6. Aitchison E, Russell N. Smoking: a major cause of polycythemia. [pathology.medresearch.in]

Prognosis Curing or removing the underlying cause of this disorder generally eliminates the symptoms. Resources OTHER "Secondary Erythrocytosis." The Merck Page. June 3, 1998. 〈http://www.merck.com〉. [encyclopedia.com]

Prognosis of polycythemia Rubra Vera Mostly prognosis is good and the median survival is 10 to 16 years. The major complications are thrombosis and hemorrhage. [labpedia.net]

Etiology

Excerpt Although the etiology of polycythemia vera remains unknown, repeated attempts have been made to correlate the condition with some cardiovascular phenomenon. [acpjournals.org]

Table 12-1 presents an etiologic framework based on different mechanisms responsible for the expansion of the red cell mass. [accessmedicine.mhmedical.com]

There are two distinct forms of the disease: Primary polycythemia (polycythemia vera) is a myeloproliferative disorder of unknown etiology. [medical-dictionary.thefreedictionary.com]

Finally, the etiology of secondary polycythemia has to be ascertained. A certain number of patients cannot be easily classified as having either PV or secondary polycythemia due to diagnostic difficulties. [pathology.medresearch.in]

Epidemiology

Summary Epidemiology It occurs mainly in male sedentary individuals, on a high-calorie diet. Prevalence is unknown. [orpha.net]

ORIGINAL PAPERS: Epidemiology results from the national inpatient sample database Krishnamoorthy, Parasurama; Gopalakrishnan, Akshayaa; Mittal, Varunb; Kalla, Aditia; Slipczuk, Leandroa; Rangaswami, Jananic; Figueredo, Vincent M.a; Messerli, Franz H.d [journals.lww.com]

Epidemiology Epidemiological data refers to the US, unless otherwise specified. Pathophysiology The JAK2 (Janus kinase 2) oncogene codes for a non-receptor tyrosine kinase in hematopoietic progenitor cells. [www-amboss-com.db.rsu.lv]

The February 2009 issue of Cancer Epidemiology, Biomarkers and Prevention article, reported on by Newswies.com pointed to the connection between environmental toxins and the number of people affected by this rare disease. [glutathionediseasecure.com]

Pathophysiology

Stress polycythemia--a pathophysiologic study M K El-Yousef et al. South Med J. 1975 May. [pubmed.ncbi.nlm.nih.gov]

However, no physiologic or pathologic basis has been found.In our study, which was designed to elicit the pathophysiology of this entity, two typical cases were studied. [jamanetwork.com]

Some factors that possibly could play a role in the pathophysiology of this syndrome were ruled out and other factors not studied here were considered for future investigation. [ncbi.nlm.nih.gov]

A case report. ( 7661388 ) 1995 2 Stress polycythemia. ( 3837011 ) Mehta B.C. 1985 3 Stress polycythemia. ( 3997770 ) Nanavati N.J....Nihalani K. 1985 4 Stress polycythemia--a pathophysiologic study. ( 165576 ) El-Yousef M.K....Bakewell W.E. 1975 5 Stress [malacards.org]

Sections of the Handbook include History of Hemorheology; Hemorheology, covering basic aspects, blood composition, blood rheology, cell mechanics, pathophysiology, methods and comparative studies; Hemodynamics, covering basic principles, microcirculation [books.google.com]

Prevention

The major goal of the treatment is to prevent thrombotic complications and haemorrhages. The amount of red blood cells is kept within the normal range (haematocrit < 0.45, haemoglobin < 145 g/l). This prevents cardiovascular deaths and thromboses. [books.google.de]

The important question now: Is there a treatment, are there preventative steps to take and what are they. The Science of the Disease To look for a cure, treatment, or how to prevent it will require looking at the science behind it. [glutathionediseasecure.com]

Therapy must also include appropriate measures to prevent continuing fluid loss. [doctor-clinic.org]

prevent blood clots and reduce the risk of serious complications. [nhs.uk]

Treatment options include the following: Phlebotomy Chemotherapy Aspirin Prevention There are no known preventative measures that will reduce your chances of getting primary polycythemia; the condition is not contagious. [cancer.uvahealth.com]

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