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Stress Polycythemia

Gaisböck Syndrome


Presentation

  • A case of stress polycythemia without symptoms of cerebral ischemia is presented.[ncbi.nlm.nih.gov]
  • Butterworth-Heinemann, ٢٢‏/١٠‏/٢٠١٣ - 1300 من الصفحات Stress in Health and Disease presents the principal pathways mediating the response to a stressor. It discusses the clinical background of cross-resistance and treatment with stress-hormones.[books.google.com]
  • 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]
  • Splenomegaly absent absent present in 75% of the cases 9. Hepatomegaly absent absent present in 35% of the cases 10. Heart or lung disease absent present absent 11. Cyanosis may be present present absent Possible References Used Back to tests[labpedia.net]
  • It is recommended that patients use the information presented as a part of a broader decision-making process. Please DO NOT STOP MEDICATIONS without first consulting a physician since doing so could be hazardous to your health.[ehealthme.com]
Fatigue
  • 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]
  • We ask about general symptoms (anxious mood, depressed mood, fatigue, pain, and stress) regardless of condition. Last updated: January 31, 2019[patientslikeme.com]
  • 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]
  • Fatigue and headache were common, and syncopal attacks occurred in four patients.[nejm.org]
  • […] bleeding due to a cut or a nosebleed Intense and frequent bone pain and/or muscle pain Headaches, lightheadedness or gastrointestinal symptoms Vision problems Ringing in the ears Difficulty or labored breathing The color of the skin appears reddish Fatigue[cancer.uvahealth.com]
Lymphadenopathy
  • Leg Ulcers 300 LeggCalvéPerthes Disease 301 Leptomeningeal Lesions 302 Leukoplakia Oral Hairy Oral Hairy Cell Leukoplakia 303 Lichen Simplex Chronicus 304 Listeriosis 305 Liver Lesions Benign Often Confused with Malignancy 306 Lumbar Disk Syndrome 307 Lymphadenopathy[books.google.de]
Popliteal Swelling
  • Swelling 397 Postconcussive Syndrome 398 Posttraumatic Stress Disorder 399 Preeclampsia 400 Premenstrual Dysphoric Disorder 401 Pronator Syndrome 402 Proteinuria 403 Pruritus Ani 404 Pseudofolliculitis Barbae Ingrown Hairs Razor Bumps 405 Pseudoinfarction[books.google.de]
Respiratory Disorders
  • It may result from a blood-forming disease that increases cell production, or it may be a physiologic response to an increased need for oxygenation in high altitudes, cardiac disease, or respiratory disorders. polycythemia, phlebotomy for, n the drawing[medical-dictionary.thefreedictionary.com]
Rhinitis
  • Phenomenon 416 Rectal Pain 417 Red Hot Joint 418 Renal Cell Adenocarcinoma 419 Renal Failure Postrenal Causes 420 Renal Tubular Acidosis 421 Respiratory Failure Hypoventilatory 422 Reticulocytosis 423 Retinopathy Hypertensive 424 Rheumatic Fever 425 Rhinitis[books.google.de]
Rectal Pain
  • Pain 417 Red Hot Joint 418 Renal Cell Adenocarcinoma 419 Renal Failure Postrenal Causes 420 Renal Tubular Acidosis 421 Respiratory Failure Hypoventilatory 422 Reticulocytosis 423 Retinopathy Hypertensive 424 Rheumatic Fever 425 Rhinitis Allergic 426[books.google.de]
Lactose Intolerance
  • Intolerance 296 Laryngitis 297 Left Axis Deviation 298 Leg Length Discrepancies 299 Leg Ulcers 300 LeggCalvéPerthes Disease 301 Leptomeningeal Lesions 302 Leukoplakia Oral Hairy Oral Hairy Cell Leukoplakia 303 Lichen Simplex Chronicus 304 Listeriosis[books.google.de]
Xerostomia
  • Paralysis 500 Volume Excess 501 Vulvar Cancer 502 Vulvovaginitis Bacterial 504 Vulvovaginitis Trichomonas 505 Weakness Gradual Onset 506 Weight Loss 507 Wheezing 508 Whiplash 509 Wrist Pain 510 Wrist and Hand Pain in Different Age Groups 511 Xanthoma 513 Xerostomia[books.google.de]
Hepatosplenomegaly
  • Later signs include pruritus, clubbing of digits, a reddened face with engorged retinal veins, and hepatosplenomegaly. Secondary polycythemia may display hypoxemia in the absence of hepatosplenomegaly and hypertension.[medical-dictionary.thefreedictionary.com]
Hypertension
  • Patients with arterial pressure elevation should be treated vigorously with close observation for control of hypertension and remission of the polycythemia. ( JAMA 229:159-162, 1974)[jamanetwork.com]
  • Some of these patients are on diuretic therapy for hypertension, which further contracts plasma volume. Again, hematological diagnosis by estimation of blood volume is needed for certainty and rational management.[alpfmedical.info]
  • Secondary polycythemia may display hypoxemia in the absence of hepatosplenomegaly and hypertension.[medical-dictionary.thefreedictionary.com]
  • […] stress polycythemia a chronic type of relative polycythemia, seen most often in middle-aged, mildly obese males who are active, anxiety-prone, and hypertensive, occurring without the characteristic symptoms associated with polycythemia vera, i.e., without[medicine.academic.ru]
  • 400 Premenstrual Dysphoric Disorder 401 Pronator Syndrome 402 Proteinuria 403 Pruritus Ani 404 Pseudofolliculitis Barbae Ingrown Hairs Razor Bumps 405 Pseudoinfarction 406 Psittacosis 407 Ptosis 408 Puberty Delayed 409 Puberty Precocious 410 Pulmonary Hypertension[books.google.de]
Jugular Venous Distention
  • Venous Distention 291 Kawasakis Disease 292 Kidney Enlargement Unilateral 293 Knee Pain in Different Age Groups 294 Korsakoffs Psychosis 295 Lactose Intolerance 296 Laryngitis 297 Left Axis Deviation 298 Leg Length Discrepancies 299 Leg Ulcers 300 LeggCalvéPerthes[books.google.de]
Osteoporosis
  • […] and Ito 351 Nodules Painful 352 Nystagmus Monocular 353 Ocular Foreign Body 354 Ophthalmoplegia1 355 Optic Atrophy 356 Oral Mucosa Pigmented Lesions 357 Oral Ulcers Acute 358 Orbital Lesions Cystic 359 Orofacial Pain 360 OsgoodSchlatter Disease 361 Osteoporosis[books.google.de]
  • Polycythemia vera (blood disorder in which the bone marrow makes too many red blood cells) has been reported by people with idiopathic thrombocytopenic purpura, high blood pressure, osteoporosis, rheumatoid arthritis, depression.[ehealthme.com]
Wrist Pain
  • Pain 510 Wrist and Hand Pain in Different Age Groups 511 Xanthoma 513 Xerostomia 514 Zenkers Diverticulum 515 Index 519 Urheberrecht[books.google.de]
Ptosis
  • Postconcussive Syndrome 398 Posttraumatic Stress Disorder 399 Preeclampsia 400 Premenstrual Dysphoric Disorder 401 Pronator Syndrome 402 Proteinuria 403 Pruritus Ani 404 Pseudofolliculitis Barbae Ingrown Hairs Razor Bumps 405 Pseudoinfarction 406 Psittacosis 407 Ptosis[books.google.de]
Flushing
  • Clinical features include facial flushing, pruritus, erythromelalgia, headaches, and dizziness. Severe complications such as thrombotic events (e.g., stroke, Budd-Chiari syndrome) may occur.[amboss.com]
  • 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]
  • 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]
  • Effects upon fishes of a periodic flushing of electrical power plants boiler tubes with chlorine. M.A. Thesis, Southern Illinois Univ. at carbondale. 37 pp. Google Scholar Davidsohn, I. & D. A. Nelson. 1969. The blood. pp. 120–330. In: I.[link.springer.com]
  • On examination, he had obvious truncal obesity and a flushed complexion. Blood pressure was 128/82 mmHg, heart rate 78/min, respiratory rate 16/min and oxygen saturations 99% on air.[brainscape.com]
Xanthoma
  • Vocal Cord Paralysis 500 Volume Excess 501 Vulvar Cancer 502 Vulvovaginitis Bacterial 504 Vulvovaginitis Trichomonas 505 Weakness Gradual Onset 506 Weight Loss 507 Wheezing 508 Whiplash 509 Wrist Pain 510 Wrist and Hand Pain in Different Age Groups 511 Xanthoma[books.google.de]
Eruptions
  • Peritoneal Carcinomatosis 383 Peritonitis Secondary 384 Periumbilical Swelling 385 Photodermatoses 386 Pinworms 387 Pityriasis Alba 388 Pleural Effusions 389 Pneumonia Bacterial 390 Pneumonia Recurrent 391 Polyarteritis Nodosa 392 Polymorphous Light Eruption[books.google.de]
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]
Auditory Hallucination
  • hallucinations but relatively normal intellectual functioning and expression of affect): 5 people, 71.43% Musculoskeletal Stiffness (stiffness of the body's muscles, joints, tendons, ligaments and nerves): 1 person, 14.29% High Blood Cholesterol: 1 person[ehealthme.com]
Delusion
  • % 40-49 : 0.0 % 50-59 : 0.0 % 60 : 0.0 % Top co-existing conditions for these people *: Schizophrenia (a mental disorder characterized by a breakdown of thought processes): 6 people, 85.71% Depression: 6 people, 85.71% Schizophrenia, Paranoid Type (delusions[ehealthme.com]
Incontinence
  • Immune Thrombocytopenic Purpura 277 Impotence 278 Incontinence Fecal 279 Infertility Male 280 Influenza 281 Interstitial Cystitis 282 Intracranial Lesion 283 Irritable Bowel Syndrome 284 Ischemic Colitis Nonocclusive 285 Jaundice 286 Jaundice in the Adult[books.google.de]
Urethral Discharge
  • Discharge and Dysuria 486 Urinary Retention Acute 487 Urine Red 488 Urolithiasis 489 Urticaria Hives 490 Uterine Myoma 491 Vaginal Bleeding Pregnancy 492 Varicocele 493 Vasculitis Diseases That Mimic Vasculitis 494 Venous Lake 495 Ventricular Septal[books.google.de]
Testicular Pain
  • Pain 468 Tetanus 469 Thromboangiitis Obliterans 470 Thrombocytopenia Inherited Disorders 471 Thrombocytopenia in Pregnancy 472 Thrombophlebitis Superficial 473 Thyroid Nodule 474 TickRelated Infections 475 Tinea Corporis 476 Tinea Versicolor Pityriasis[books.google.de]
Headache
  • 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]
  • 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]
  • Clinical features include facial flushing, pruritus, erythromelalgia, headaches, and dizziness. Severe complications such as thrombotic events (e.g., stroke, Budd-Chiari syndrome) may occur.[amboss.com]
  • Fatigue and headache were common, and syncopal attacks occurred in four patients.[nejm.org]
  • Symptoms may include: Abnormal and heavy bleeding due to a cut or a nosebleed Intense and frequent bone pain and/or muscle pain Headaches, lightheadedness or gastrointestinal symptoms Vision problems Ringing in the ears Difficulty or labored breathing[cancer.uvahealth.com]
Dizziness
  • Clinical features include facial flushing, pruritus, erythromelalgia, headaches, and dizziness. Severe complications such as thrombotic events (e.g., stroke, Budd-Chiari syndrome) may occur.[amboss.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]
  • 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]
  • Polycythemia Vera clinical features: Face appears suffused with blood, retinal veins are engorged, frequent headaches, dizziness, blurred vision and tinnitus.[quizlet.com]
  • 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]
Irritability
  • 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]
  • Immune Thrombocytopenic Purpura 277 Impotence 278 Incontinence Fecal 279 Infertility Male 280 Influenza 281 Interstitial Cystitis 282 Intracranial Lesion 283 Irritable Bowel Syndrome 284 Ischemic Colitis Nonocclusive 285 Jaundice 286 Jaundice in the Adult[books.google.de]
Lethargy
  • 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]
Papilledema
  • Orbital Lesions Cystic 359 Orofacial Pain 360 OsgoodSchlatter Disease 361 Osteoporosis 362 Otitis Externa 363 Ovarian Mass 364 Pagets Disease of Bone 365 Pain Midfoot 366 Pain Posterior Heel 367 Palpitations 368 Pancreatitis Acute 369 Panic Disorder 370 Papilledema[books.google.de]

Workup

  • 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]
  • See Presentation and Workup. To the extent that the increased RBCs alleviate tissue hypoxia, secondary polycythemia may in fact be beneficial.[emedicine.medscape.com]
Left Axis Deviation
  • Axis Deviation 298 Leg Length Discrepancies 299 Leg Ulcers 300 LeggCalvéPerthes Disease 301 Leptomeningeal Lesions 302 Leukoplakia Oral Hairy Oral Hairy Cell Leukoplakia 303 Lichen Simplex Chronicus 304 Listeriosis 305 Liver Lesions Benign Often Confused[books.google.de]
Decreased Plasma Volume
  • In relative (spurious) erythrocytosis, the RBC mass is normal and the elevated Hct is caused by a decreased plasma volume (see Table 95.3 ). This is also referred to as stress polycythemia or Gaisböck's syndrome.[163.178.103.176]
  • Relative/pseudo polycythaemia occurs due to decreased plasma volume. This may occur due to dehydration (eg vomiting, diarrhoea, diuretics) A special form of relative polycythaemia is Gaisbocks.[mrcpandme.blogspot.com]
  • It results from decreasing plasma volume and subsequent hemoconcentration. This disease is also known as relative polycythemia, stress erythrocytosis, stress polycythemia, benign polycythemia. Gaisböck's syndrome, and pseudopolycythemia.[doctor-clinic.org]
  • Polycythaemia can be relative (decreased plasma volume) or true polycythaemia.[rcpa.edu.au]

Treatment

  • Research on treatment modalities is ongoing.[medical-dictionary.thefreedictionary.com]
  • After 6 months of treatment, the TOS, OSI and MDA levels were significantly decreased in treated patients compared to before treatment.[karger.com]
  • It discusses the clinical background of cross-resistance and treatment with stress-hormones. It addresses the diseases of adaptation or stress diseases, diagnostic indicators, and functional changes.[books.google.com]

Prognosis

  • 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]
  • Polycythemia Vera prognosis: Chronic disease- patient lives 10-20 years with therapy. In 15-20% of patients, after about 10 years the disease gives rise to a "spent" stage. Life expectancy is then about 3 years. Bone marrow becomes fibrotic.[quizlet.com]
  • Prognosis If you have PV, your prognosis depends on many factors including your age, other illnesses you have, and PV complications you may develop with PV.[mpnvoice.org.uk]
  • Prognosis Curing or removing the underlying cause of this disorder generally eliminates the symptoms. Resources OTHER "Secondary Erythrocytosis." The Merck Page. June 3, 1998. 〈 〉.[encyclopedia.com]

Etiology

  • There are two distinct forms of the disease: Primary polycythemia (polycythemia vera) is a myeloproliferative disorder of unknown etiology.[medical-dictionary.thefreedictionary.com]
  • PV is a disorder of unknown etiology involving a multipotent hematopoietic progenitor cell that is characterized by the accumulation of phenotypically normal red blood cells, white blood cells, and platelets in the absence of a definable cause; extramedullary[raysahelian.com]
  • Leopold SS: The etiology of pulmonary arteriosclerosis (Ayerza’s syndrome). Am J Med 219:152, 1950. 9. Abbott ME: Atlas of Congenital Heart Disease. American Heart Association, New York, 1936. 10.[medtextfree.wordpress.com]
  • Subjects with any active medical illnesses that could be etiologically related to the ongoing depressive episode (e.g. untreated hypothyroidism, cardiovascular accident within the past 6 months, uncontrolled hypertension or diabetes), and who were pregnant[journals.plos.org]

Epidemiology

  • 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]
  • Epidemiology The frequency of secondary polycythemia depends on the underlying disease. The mortality and morbidity of secondary polycythemia depend on the underlying condition. Tefferi A, Barbui T.[emedicine.medscape.com]
  • Modan B: An epidemiological study of polycythemia vera. Blood 26:657, 1965. 30. Berglund S, Zettervall O: Incidence of polycythemia vera in a defined population. Eur J Haematol 48:20, 1992. 31.[medtextfree.wordpress.com]
Sex distribution
Age distribution

Pathophysiology

  • 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]
  • The pathophysiology of smokers polycythemia is believed to be multifactorial. Suspected causes include a reduced plasma volume and an elevated red cell mass secondary to increased levels of carboxyhemoglobin.[thebigl.co]

Prevention

  • Rest should be balanced with exercise, but the patient should be advised that activity and ambulation help prevent thrombotic complications.[medical-dictionary.thefreedictionary.com]
  • In response to increased oxidative stress, living organisms develop an antioxidant defense to prevent the harmful effects of free oxygen radicals.[karger.com]
  • 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]
  • Therapy must also include appropriate measures to prevent continuing fluid loss.[doctor-clinic.org]
  • 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]

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