Polycythemia Vera: Causes, Symptoms, Risk Factors, Diagnosis, Treatment and Complications

Polycythemia vera is the name of one type of blood cancer. Your bone marrow produces an excessive amount of red blood cells as a result. These excess cells can cause potentially fatal conditions like blood clots by thickening and decreasing the flow of your blood.

Polycythemia Vera is uncommon. It usually takes time to grow, and you might not notice it for years at a time. The condition is often discovered by a blood test ordered for another purpose.

If untreated, polycythemia vera can be lethal. On the other hand, the symptoms, indicators, and complications of the condition may be lessened with the appropriate medical care.

Causes Of Polycythemia Vera 

An abnormality in a gene that affects the synthesis of red blood cells is known as polycythemia vera. Red blood cells, white blood cells, and platelets are the three types of blood cells that your body constantly adjusts in different amounts. Your bone marrow, however, creates an excess of some blood cells if you have polycythemia vera.

Though the exact etiology of the gene mutation causing polycythemia vera is still unknown, most cases do not result from parental inheritance.

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Symptoms Of Polycythemia Vera 

Many people who have polycythemia vera do not show any obvious symptoms. Uncertain symptoms such as headache, dizziness, fatigue, and blurred vision may be experienced by some people.

Here are some additional specific indicators of polycythemia vera:

• Tingling, burning, numbness, or weakness in your arms, legs, or feet itching, especially after taking a warm bath or shower
• Shortness of breath and breathing problems when at rest; rapid feeling of fullness after eating; bloating or pain in your upper left abdomen due to an enlarged spleen; unusual bleeding, such as gum or nosebleeds; painful enlargement in just one joint, usually the big toe.

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Risk Factors Of Polycythemia vera 

Adults between the ages of 50 and 75 are the most typically affected, while polycythemia vera can affect anyone at any age. Polycythemia vera affects women sooner in life, even though men are affected more commonly.

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Diagnosis Of Polycythemia vera 

Your doctor will take a complete medical history in addition to performing a physical examination.

Blood tests

When polycythemia vera is diagnosed, a blood test could reveal:

• Higher than normal concentrations of platelets, white blood cells, and red blood cells
• An increased red blood cell percentage about the overall amount of blood (measured by hematocrit)
• Higher levels of hemoglobin, the iron-rich protein that carries oxygen in red blood cells

Bone marrow aspiration or biopsy

If your doctor suspects polycythemia vera, they can advise getting a bone marrow sample by a bone marrow aspiration or biopsy.

For a bone marrow biopsy, a sample of solid bone marrow is obtained. A bone marrow aspiration is typically carried out in parallel. During an aspiration, your doctor takes a sample of the liquid part of your marrow.

Specific genetic testing

A bone marrow or blood test may identify the gene mutation associated with polycythemia vera if you have the condition.

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Treatment Of Polycythemia vera 

Treatment for Vera is unknown. Reducing the probability of issues is the aim of therapy. Additionally, you may feel less discomfort with these therapies.

Blood withdrawals

Phlebotomy, or getting regular blood draws through a vein, is the most widely used treatment for polycythemia vera. It follows the same procedure to donate blood.

You have less blood overall and fewer red blood cells overall as a result of this. The severity of your condition dictates how often you need blood work.

Methods for reducing itching

If you're experiencing bothersome itching, your doctor might suggest UV light therapy or prescription medication like antihistamines.

Selective serotonin reuptake inhibitors (SSRIs), which are commonly taken to treat depression, have been shown in clinical trials to help reduce itching. Two types of selective serotonin reuptake inhibitors (SSRIs) are paroxetine (Brisdelle, Paxil, Pexeva, and others) and fluoxetine (Prozac, Sarafem, Selfemra, and others).

Drugs that decrease red blood cell production

Your doctor may prescribe medications to reduce the amount of red blood cells in your blood if phlebotomy proves to be inadequately beneficial. Take into consideration, for instance:

• Heart-related drugs
• Ruxolitinib 
• Busulfan 
• Alpha-2b interferon 
• Droxia and Hydrea, or Hydroxyurea

Additionally, your doctor will likely prescribe medication to treat heart and blood vessel disease risk factors such as diabetes, hypertension, and elevated cholesterol.

Your doctor may suggest taking a low dose of aspirin to reduce your risk of blood clots. A small amount of aspirin may also help to relieve searing pain in your hands or feet.

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Complications Of Polycythemia vera 

The following are possible adverse effects of polycythemia vera:

• Blood clots: Blood clots are more common in those with abnormal platelets, thicker blood, and decreased blood flow. Blood clots can cause a blockage in a vein deep within a calf muscle, an obstruction in an artery going to the lungs, or a vein in the belly.
• Enlarged spleen: The spleen not only helps the body fight illness, but it also removes materials such as old or damaged red blood cells. Your spleen grows larger because it has to work harder than usual to process the extra blood cells that polycythemia vera causes.
• Problems caused by high levels of red blood cells: Overproduction of red blood cells can lead to a host of additional problems, including gout, which is inflammation of the joints, and peptic ulcers, which are open sores on the inside lining of the stomach, upper small intestine, or esophagus.
• Other blood disorders: Seldom can polycythemia vera lead to other blood problems, such as acute leukemia (blood and bone marrow cancer), a progressive disease where bone marrow is replaced with scar tissue, or a disorder where stem cells do not grow or function normally.

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