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class="vector-toc-numb">2</span> <span>Differential diagnoses</span> </div> </a> <button aria-controls="toc-Differential_diagnoses-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Differential diagnoses subsection</span> </button> <ul id="toc-Differential_diagnoses-sublist" class="vector-toc-list"> <li id="toc-Polycythemia_in_adults" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Polycythemia_in_adults"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.1</span> <span>Polycythemia in adults</span> </div> </a> <ul id="toc-Polycythemia_in_adults-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Polycythemia_in_neonates" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Polycythemia_in_neonates"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.2</span> <span>Polycythemia in neonates</span> </div> </a> <ul id="toc-Polycythemia_in_neonates-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Pathophysiology" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Pathophysiology"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Pathophysiology</span> </div> </a> <ul id="toc-Pathophysiology-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Evaluation" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Evaluation"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Evaluation</span> </div> </a> <button aria-controls="toc-Evaluation-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Evaluation subsection</span> </button> <ul id="toc-Evaluation-sublist" class="vector-toc-list"> <li id="toc-History_and_physical_exam" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#History_and_physical_exam"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.1</span> <span>History and physical exam</span> </div> </a> <ul id="toc-History_and_physical_exam-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Laboratory_evaluation" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Laboratory_evaluation"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.2</span> <span>Laboratory evaluation</span> </div> </a> <ul id="toc-Laboratory_evaluation-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Additional_testing" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Additional_testing"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.3</span> <span>Additional testing</span> </div> </a> <ul id="toc-Additional_testing-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Absolute_polycythemia" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Absolute_polycythemia"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>Absolute polycythemia</span> </div> </a> <button aria-controls="toc-Absolute_polycythemia-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Absolute polycythemia subsection</span> </button> <ul id="toc-Absolute_polycythemia-sublist" class="vector-toc-list"> <li id="toc-Primary_polycythemia" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Primary_polycythemia"> <div class="vector-toc-text"> <span class="vector-toc-numb">5.1</span> <span>Primary polycythemia</span> </div> </a> <ul id="toc-Primary_polycythemia-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Secondary_polycythemia" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Secondary_polycythemia"> <div class="vector-toc-text"> <span class="vector-toc-numb">5.2</span> <span>Secondary polycythemia</span> </div> </a> <ul id="toc-Secondary_polycythemia-sublist" class="vector-toc-list"> <li id="toc-Altered_oxygen_sensing" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Altered_oxygen_sensing"> <div class="vector-toc-text"> <span class="vector-toc-numb">5.2.1</span> <span>Altered oxygen sensing</span> </div> </a> <ul id="toc-Altered_oxygen_sensing-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> </ul> </li> <li id="toc-Symptoms" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Symptoms"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>Symptoms</span> </div> </a> <ul id="toc-Symptoms-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Epidemiology" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Epidemiology"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>Epidemiology</span> </div> </a> <ul id="toc-Epidemiology-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Management" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Management"> <div class="vector-toc-text"> <span class="vector-toc-numb">8</span> <span>Management</span> </div> </a> <button aria-controls="toc-Management-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Management subsection</span> </button> <ul id="toc-Management-sublist" class="vector-toc-list"> <li id="toc-Relation_to_athletic_performance" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Relation_to_athletic_performance"> <div class="vector-toc-text"> <span class="vector-toc-numb">8.1</span> <span>Relation to athletic performance</span> </div> </a> <ul id="toc-Relation_to_athletic_performance-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-See_also" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#See_also"> <div class="vector-toc-text"> <span class="vector-toc-numb">9</span> <span>See also</span> </div> </a> <ul id="toc-See_also-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">10</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> <span class="vector-toc-numb">11</span> <span>External links</span> </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-listBullet mw-ui-icon-wikimedia-listBullet"></span> <span class="vector-dropdown-label-text">Toggle the table of contents</span> </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">Polycythemia</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 30 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-30" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">30 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D9%83%D8%AB%D8%B1%D8%A9_%D9%83%D8%B1%D9%8A%D8%A7%D8%AA_%D8%A7%D9%84%D8%AF%D9%85_%D8%A7%D9%84%D8%AD%D9%85%D8%B1" title="كثرة كريات الدم الحمر – Arabic" lang="ar" hreflang="ar" data-title="كثرة كريات الدم الحمر" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-bs mw-list-item"><a href="https://bs.wikipedia.org/wiki/Policitemija" title="Policitemija – Bosnian" lang="bs" hreflang="bs" data-title="Policitemija" data-language-autonym="Bosanski" data-language-local-name="Bosnian" class="interlanguage-link-target"><span>Bosanski</span></a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Policit%C3%A8mia" title="Policitèmia – Catalan" lang="ca" hreflang="ca" data-title="Policitèmia" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target"><span>Català</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Polyglobulie" title="Polyglobulie – German" lang="de" hreflang="de" data-title="Polyglobulie" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-et mw-list-item"><a href="https://et.wikipedia.org/wiki/Pol%C3%BCts%C3%BCteemia" title="Polütsüteemia – Estonian" lang="et" hreflang="et" data-title="Polütsüteemia" data-language-autonym="Eesti" data-language-local-name="Estonian" class="interlanguage-link-target"><span>Eesti</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Policitemia" title="Policitemia – Spanish" lang="es" hreflang="es" data-title="Policitemia" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-eu mw-list-item"><a href="https://eu.wikipedia.org/wiki/Polizitemia" title="Polizitemia – Basque" lang="eu" hreflang="eu" data-title="Polizitemia" data-language-autonym="Euskara" data-language-local-name="Basque" class="interlanguage-link-target"><span>Euskara</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D9%BE%D9%84%DB%8C%E2%80%8C%D8%B3%DB%8C%D8%AA%D9%85%DB%8C" title="پلی‌سیتمی – Persian" lang="fa" hreflang="fa" data-title="پلی‌سیتمی" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Polyglobulie" title="Polyglobulie – French" lang="fr" hreflang="fr" data-title="Polyglobulie" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-ga mw-list-item"><a href="https://ga.wikipedia.org/wiki/Polaic%C3%ADotaemacht" title="Polaicíotaemacht – Irish" lang="ga" hreflang="ga" data-title="Polaicíotaemacht" data-language-autonym="Gaeilge" data-language-local-name="Irish" class="interlanguage-link-target"><span>Gaeilge</span></a></li><li class="interlanguage-link interwiki-hr mw-list-item"><a href="https://hr.wikipedia.org/wiki/Policitemija" title="Policitemija – Croatian" lang="hr" hreflang="hr" data-title="Policitemija" data-language-autonym="Hrvatski" data-language-local-name="Croatian" class="interlanguage-link-target"><span>Hrvatski</span></a></li><li class="interlanguage-link interwiki-id mw-list-item"><a href="https://id.wikipedia.org/wiki/Polisitemia" title="Polisitemia – Indonesian" lang="id" hreflang="id" data-title="Polisitemia" data-language-autonym="Bahasa Indonesia" data-language-local-name="Indonesian" class="interlanguage-link-target"><span>Bahasa Indonesia</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Policitemia" title="Policitemia – Italian" lang="it" hreflang="it" data-title="Policitemia" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%A4%D7%95%D7%9C%D7%99%D7%A6%D7%99%D7%98%D7%9E%D7%99%D7%94" title="פוליציטמיה – Hebrew" lang="he" hreflang="he" data-title="פוליציטמיה" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target"><span>עברית</span></a></li><li class="interlanguage-link interwiki-lt mw-list-item"><a href="https://lt.wikipedia.org/wiki/Eritrocitoz%C4%97" title="Eritrocitozė – Lithuanian" lang="lt" hreflang="lt" data-title="Eritrocitozė" data-language-autonym="Lietuvių" data-language-local-name="Lithuanian" class="interlanguage-link-target"><span>Lietuvių</span></a></li><li class="interlanguage-link interwiki-mk mw-list-item"><a href="https://mk.wikipedia.org/wiki/%D0%9F%D0%BE%D0%BB%D0%B8%D1%86%D0%B8%D1%82%D0%B5%D0%BC%D0%B8%D1%98%D0%B0" title="Полицитемија – Macedonian" lang="mk" hreflang="mk" data-title="Полицитемија" data-language-autonym="Македонски" data-language-local-name="Macedonian" class="interlanguage-link-target"><span>Македонски</span></a></li><li class="interlanguage-link interwiki-ml mw-list-item"><a href="https://ml.wikipedia.org/wiki/%E0%B4%AA%E0%B5%8B%E0%B4%B3%E0%B4%BF%E0%B4%B8%E0%B5%88%E0%B4%A4%E0%B5%8D%E0%B4%A4%E0%B5%80%E0%B4%AE%E0%B4%BF%E0%B4%AF" title="പോളിസൈത്തീമിയ – Malayalam" lang="ml" hreflang="ml" data-title="പോളിസൈത്തീമിയ" data-language-autonym="മലയാളം" data-language-local-name="Malayalam" class="interlanguage-link-target"><span>മലയാളം</span></a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Polycythemie" title="Polycythemie – Dutch" lang="nl" hreflang="nl" data-title="Polycythemie" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target"><span>Nederlands</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E5%A4%9A%E8%A1%80%E7%97%87" title="多血症 – Japanese" lang="ja" hreflang="ja" data-title="多血症" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Nadkrwisto%C5%9B%C4%87" title="Nadkrwistość – Polish" lang="pl" hreflang="pl" data-title="Nadkrwistość" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Poliglobulia" title="Poliglobulia – Portuguese" lang="pt" hreflang="pt" data-title="Poliglobulia" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-ro mw-list-item"><a href="https://ro.wikipedia.org/wiki/Policitemie" title="Policitemie – Romanian" lang="ro" hreflang="ro" data-title="Policitemie" data-language-autonym="Română" data-language-local-name="Romanian" class="interlanguage-link-target"><span>Română</span></a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%9F%D0%BE%D0%BB%D0%B8%D1%86%D0%B8%D1%82%D0%B5%D0%BC%D0%B8%D1%8F" title="Полицитемия – Russian" lang="ru" hreflang="ru" data-title="Полицитемия" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-simple mw-list-item"><a href="https://simple.wikipedia.org/wiki/Polycythemia" title="Polycythemia – Simple English" lang="en-simple" hreflang="en-simple" data-title="Polycythemia" data-language-autonym="Simple English" data-language-local-name="Simple English" class="interlanguage-link-target"><span>Simple English</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/Policitemija" title="Policitemija – Serbian" lang="sr" hreflang="sr" data-title="Policitemija" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a href="https://fi.wikipedia.org/wiki/Polysytemia" title="Polysytemia – Finnish" lang="fi" hreflang="fi" data-title="Polysytemia" data-language-autonym="Suomi" data-language-local-name="Finnish" class="interlanguage-link-target"><span>Suomi</span></a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Polycytemi" title="Polycytemi – Swedish" lang="sv" hreflang="sv" data-title="Polycytemi" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target"><span>Svenska</span></a></li><li class="interlanguage-link interwiki-th mw-list-item"><a href="https://th.wikipedia.org/wiki/%E0%B9%80%E0%B8%A1%E0%B9%87%E0%B8%94%E0%B9%80%E0%B8%A5%E0%B8%B7%E0%B8%AD%E0%B8%94%E0%B9%81%E0%B8%94%E0%B8%87%E0%B8%A1%E0%B8%B2%E0%B8%81" title="เม็ดเลือดแดงมาก – Thai" lang="th" hreflang="th" data-title="เม็ดเลือดแดงมาก" data-language-autonym="ไทย" data-language-local-name="Thai" class="interlanguage-link-target"><span>ไทย</span></a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/Polisitemi" title="Polisitemi – Turkish" lang="tr" hreflang="tr" data-title="Polisitemi" data-language-autonym="Türkçe" data-language-local-name="Turkish" class="interlanguage-link-target"><span>Türkçe</span></a></li><li class="interlanguage-link interwiki-zh mw-list-item"><a href="https://zh.wikipedia.org/wiki/%E7%BA%A2%E7%BB%86%E8%83%9E%E5%A2%9E%E5%A4%9A%E7%97%87" title="红细胞增多症 – Chinese" lang="zh" hreflang="zh" data-title="红细胞增多症" data-language-autonym="中文" data-language-local-name="Chinese" class="interlanguage-link-target"><span>中文</span></a></li> </ul> <div class="after-portlet after-portlet-lang"><span class="wb-langlinks-edit wb-langlinks-link"><a href="https://www.wikidata.org/wiki/Special:EntityPage/Q933716#sitelinks-wikipedia" title="Edit interlanguage links" class="wbc-editpage">Edit links</a></span></div> </div> </div> </div> </header> <div class="vector-page-toolbar"> <div class="vector-page-toolbar-container"> <div id="left-navigation"> <nav aria-label="Namespaces"> <div id="p-associated-pages" class="vector-menu vector-menu-tabs mw-portlet mw-portlet-associated-pages" > <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li id="ca-nstab-main" class="selected vector-tab-noicon mw-list-item"><a href="/wiki/Polycythemia" title="View the content page [c]" accesskey="c"><span>Article</span></a></li><li id="ca-talk" class="vector-tab-noicon mw-list-item"><a href="/wiki/Talk:Polycythemia" rel="discussion" 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id="siteSub" class="noprint">From Wikipedia, the free encyclopedia</div> </div> <div id="contentSub"><div id="mw-content-subtitle"><span class="mw-redirectedfrom">(Redirected from <a href="/w/index.php?title=Osler%E2%80%93Vaquez_disease&redirect=no" class="mw-redirect" title="Osler–Vaquez disease">Osler–Vaquez disease</a>)</span></div></div> <div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Laboratory diagnosis of high hemoglobin content in blood</div> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox ib-medical-condition"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Polycythemia</th></tr><tr style="background-color: #f8f9fa;"><td colspan="2" class="infobox-full-data"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:1901_Composition_of_Blood.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/4/4d/1901_Composition_of_Blood.jpg/220px-1901_Composition_of_Blood.jpg" decoding="async" width="220" height="138" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/4/4d/1901_Composition_of_Blood.jpg/330px-1901_Composition_of_Blood.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/4/4d/1901_Composition_of_Blood.jpg/440px-1901_Composition_of_Blood.jpg 2x" data-file-width="1517" data-file-height="950" /></a></span></td></tr><tr><td colspan="2" class="infobox-full-data">Diagram illustrating normal composition of blood compared to anemia and polycythemia</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Hematology" title="Hematology">Hematology</a></td></tr></tbody></table> <p><b>Polycythemia</b> (also known as <b>polycythaemia</b>) is a laboratory finding in which the <a href="/wiki/Hematocrit" title="Hematocrit">hematocrit</a> (the <a href="/wiki/Volume_percent" class="mw-redirect" title="Volume percent">volume percentage</a> of <a href="/wiki/Red_blood_cell" title="Red blood cell">red blood cells</a> in the <a href="/wiki/Blood" title="Blood">blood</a>) and/or <a href="/wiki/Hemoglobin" title="Hemoglobin">hemoglobin</a> concentration are increased in the blood. Polycythemia is sometimes called <b>erythrocytosis</b>, and there is significant overlap in the two findings, but the terms are not the same: polycythemia describes any increase in hematocrit and/or hemoglobin, while erythrocytosis describes an increase specifically in the number of red blood cells in the blood.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (October 2024)">citation needed</span></a></i>]</sup> </p><p>Polycythemia has many causes. It can describe an increase in the number of <a href="/wiki/Red_blood_cell" title="Red blood cell">red blood cells</a><sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> ("absolute polycythemia") or to a decrease in the volume of plasma ("relative polycythemia").<sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Absolute polycythemia can be due to genetic mutations in the bone marrow ("primary polycythemia"), physiologic adaptations to one's environment, medications, and/or other health conditions.<sup id="cite_ref-:9_3-0" class="reference"><a href="#cite_note-:9-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-:5_4-0" class="reference"><a href="#cite_note-:5-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Laboratory studies such as serum <a href="/wiki/Erythropoietin" title="Erythropoietin">erythropoeitin</a> levels and <a href="/wiki/Genetic_testing" title="Genetic testing">genetic testing</a> might be helpful to clarify the cause of polycythemia if the physical exam and patient history do not reveal a likely cause.<sup id="cite_ref-:4_5-0" class="reference"><a href="#cite_note-:4-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p><p>Mild polycythemia on its own is often asymptomatic. Treatment for polycythemia varies, and typically involves treating its underlying cause.<sup id="cite_ref-:11_6-0" class="reference"><a href="#cite_note-:11-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> Treatment of primary polycythemia (see <a href="/wiki/Polycythemia_vera" title="Polycythemia vera">polycythemia vera</a>) could involve <a href="/wiki/Phlebotomy" title="Phlebotomy">phlebotomy</a>, antiplatelet therapy to reduce risk of blood clots, and additional cytoreductive therapy to reduce the number of red blood cells produced in the bone marrow.<sup id="cite_ref-:3_7-0" class="reference"><a href="#cite_note-:3-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Definition">Definition</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Polycythemia&action=edit&section=1" title="Edit section: Definition"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Polycythemia is defined as serum hematocrit (Hct) or hemoglobin (HgB) exceeding normal ranges expected for age and sex, typically Hct >49% in healthy adult men and >48% in women, or HgB >16.5 g/dL in men or >16.0 g/dL in women.<sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> The definition is different for neonates and varies by age in children.<sup id="cite_ref-:0_9-0" class="reference"><a href="#cite_note-:0-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-:1_10-0" class="reference"><a href="#cite_note-:1-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Differential_diagnoses">Differential diagnoses</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Polycythemia&action=edit&section=2" title="Edit section: Differential diagnoses"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Polycythemia_in_adults">Polycythemia in adults</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Polycythemia&action=edit&section=3" title="Edit section: Polycythemia in adults"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Different diseases or conditions can cause polycythemia in adults. These processes are discussed in more detail in their respective sections below. </p><p><b>Relative polycythemia</b> is not a true increase in the number of red blood cells or hemoglobin in the blood, but rather an elevated laboratory finding caused by reduced blood plasma (<a href="/wiki/Hypovolemia" title="Hypovolemia">hypovolemia</a>, cf. <a href="/wiki/Dehydration" title="Dehydration">dehydration</a>). Relative polycythemia is often caused by loss of <a href="/wiki/Body_fluid" title="Body fluid">body fluids</a>, such as through burns, dehydration, and stress.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (December 2020)">citation needed</span></a></i>]</sup> A specific type of relative polycythemia is Gaisböck syndrome. In this syndrome, primarily occurring in <a href="/wiki/Obesity" title="Obesity">obese</a> men, <a href="/wiki/Hypertension" title="Hypertension">hypertension</a> causes a reduction in plasma volume, resulting in (amongst other changes) a relative increase in red blood cell count.<sup id="cite_ref-11" class="reference"><a href="#cite_note-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> If relative polycythemia is deemed unlikely because the patient has no other signs of hemoconcentration, and has sustained polycythemia without clear loss of body fluids, the patient likely has <b>absolute</b> or true polycythemia. </p><p><b>Absolute polycythemia</b> can be split into two categories: </p> <ul><li><b>Primary polycythemia</b> is the overproduction of red blood cells due to a primary process in the bone marrow (a so-called <a href="/wiki/Myeloproliferative_disease" class="mw-redirect" title="Myeloproliferative disease">myeloproliferative disease</a>). These can be familial or congenital, or acquired later in life.<sup id="cite_ref-:2_12-0" class="reference"><a href="#cite_note-:2-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup></li> <li><b>Secondary polycythemia</b> is the most common cause of polycythemia. It occurs in reaction to chronically <a href="/wiki/Hypoxia_(medical)" class="mw-redirect" title="Hypoxia (medical)">low oxygen levels</a>, medications, other genetic mutations that impact the body's ability to transport or detect oxygen, or, rarely because of certain cancers.<sup id="cite_ref-:5_4-1" class="reference"><a href="#cite_note-:5-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup></li> <li>Alternatively, additional red blood cells may have been received through another process—for example, being over-transfused (either accidentally or, as <a href="/wiki/Blood_doping" title="Blood doping">blood doping</a>, deliberately).<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (December 2020)">citation needed</span></a></i>]</sup></li></ul> <div class="mw-heading mw-heading3"><h3 id="Polycythemia_in_neonates">Polycythemia in neonates</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Polycythemia&action=edit&section=4" title="Edit section: Polycythemia in neonates"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Polycythemia in newborns is defined as hematocrit > 65%. Significant polycythemia can be associated with blood hyperviscosity, or thickening of the blood. Causes of neonatal polycythemia include: </p> <ul><li><b>Hypoxia:</b> Poor oxygen delivery (hypoxia) in utero resulting in compensatory increased production of red blood cells (<a href="/wiki/Erythropoiesis" title="Erythropoiesis">erythropoeisis</a>). Hypoxia can be either acute or chronic. Acute hypoxia can occur as a result of perinatal complications. Chronic fetal hypoxia is associated with maternal risk factors such as hypertension, diabetes and smoking.<sup id="cite_ref-:1_10-1" class="reference"><a href="#cite_note-:1-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup></li> <li><b>Umbilical cord stripping</b>: delayed cord clamping and the stripping of the umbilical cord towards the baby can cause the residual blood in the cord/placenta to enter fetal circulation, which can increase blood volume.<sup id="cite_ref-:1_10-2" class="reference"><a href="#cite_note-:1-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup></li> <li>The recipient twin in a pregnancy undergoing <a href="/wiki/Twin-to-twin_transfusion_syndrome" title="Twin-to-twin transfusion syndrome">twin-to-twin transfusion syndrome</a> can have polycythemia.<sup id="cite_ref-13" class="reference"><a href="#cite_note-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup></li></ul> <div class="mw-heading mw-heading2"><h2 id="Pathophysiology">Pathophysiology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Polycythemia&action=edit&section=5" title="Edit section: Pathophysiology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The pathophysiology of polycythemia varies based on its cause. The production of red blood cells (or erythropoeisis) in the body is regulated by <a href="/wiki/Erythropoietin" title="Erythropoietin">erythropoietin</a>, which is a protein produced by the kidneys in response to poor oxygen delivery.<sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> As a result, more erythropoeitin is produced to encourage red blood cell production and increase oxygen-carrying capacity. This results in secondary polycythemia, which can be an appropriate response to hypoxic conditions such as chronic smoking, obstructive sleep apnea, and high altitude.<sup id="cite_ref-:5_4-2" class="reference"><a href="#cite_note-:5-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Furthermore, certain genetic conditions can impair the body's accurate detection of oxygen levels in the serum, which leads to excess erythropoeitin production even without hypoxia or impaired oxygen delivery to tissues.<sup id="cite_ref-:7_15-0" class="reference"><a href="#cite_note-:7-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-:8_16-0" class="reference"><a href="#cite_note-:8-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> Alternatively, certain types of cancers, most notably renal cell carcinoma, and medications such as testosterone use can cause inappropriate erythropoeitin production that stimulates red cell production despite adequate oxygen delivery.<sup id="cite_ref-:10_17-0" class="reference"><a href="#cite_note-:10-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> </p><p>Primary polycythemia, on the other hand, is caused by genetic mutations or defects of the red cell progenitors within the bone marrow, leading to overgrowth and hyperproliferation of red blood cells regardless of erythropoeitin levels.<sup id="cite_ref-:9_3-1" class="reference"><a href="#cite_note-:9-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p><p>Increased hematocrit and red cell mass with polycythemia increases the viscosity of blood, leading to impaired blood flow and contributing to an increased risk of clotting (thrombosis).<sup id="cite_ref-18" class="reference"><a href="#cite_note-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Evaluation">Evaluation</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Polycythemia&action=edit&section=6" title="Edit section: Evaluation"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="History_and_physical_exam">History and physical exam</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Polycythemia&action=edit&section=7" title="Edit section: History and physical exam"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The first step to evaluate new polycythemia in any individual is to conduct a detailed history and physical exam.<sup id="cite_ref-:2_12-1" class="reference"><a href="#cite_note-:2-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> Patients should be asked about smoking history, altitude, medication use, personal bleeding and clotting history, symptoms of <a href="/wiki/Sleep_apnea" title="Sleep apnea">sleep apnea</a> (snoring, apneic episodes), and any family history of hematologic conditions or polycythemia. A thorough cardiopulmonary exam including auscultation of the heart and lungs can help evaluate for cardiac shunting or chronic pulmonary disease. An abdominal exam can assess for <a href="/wiki/Splenomegaly" title="Splenomegaly">splenomegaly</a>, which can be seen in polycythemia vera. Examination of digits for <a href="/wiki/Erythromelalgia" title="Erythromelalgia">erythromelalgia</a>, <a href="/wiki/Nail_clubbing" title="Nail clubbing">clubbing</a> or <a href="/wiki/Cyanosis" title="Cyanosis">cyanosis</a> can help assess for chronic hypoxia.<sup id="cite_ref-:2_12-2" class="reference"><a href="#cite_note-:2-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Laboratory_evaluation">Laboratory evaluation</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Polycythemia&action=edit&section=8" title="Edit section: Laboratory evaluation"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Polycythemia is often initially identified on a <a href="/wiki/Complete_blood_count" title="Complete blood count">complete blood count</a> (CBC). The CBC is often repeated to evaluate for persistent polycythemia.<sup id="cite_ref-:2_12-3" class="reference"><a href="#cite_note-:2-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> If an etiology of polycythemia is unclear from history or physical, additional laboratory evaluation might include:<sup id="cite_ref-:4_5-1" class="reference"><a href="#cite_note-:4-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p> <ul><li>Blood smear to evaluate cell morphology<sup id="cite_ref-:3_7-1" class="reference"><a href="#cite_note-:3-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup></li> <li>Iron panel to evaluate for concurrent <a href="/wiki/Iron_deficiency" title="Iron deficiency">iron deficiency</a></li> <li><a href="/wiki/Janus_kinase_2" title="Janus kinase 2">JAK2</a> mutation testing<sup id="cite_ref-:2_12-4" class="reference"><a href="#cite_note-:2-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup></li> <li>Serum <a href="/wiki/Erythropoietin" title="Erythropoietin">erythropoeitin</a> (EPO) levels<sup id="cite_ref-:4_5-2" class="reference"><a href="#cite_note-:4-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup></li> <li>Oxygen saturation (usually via <a href="/wiki/Pulse_oximetry" title="Pulse oximetry">pulse oximetry</a> or <a href="/wiki/Blood_gas_test" title="Blood gas test">blood gas</a> tests) or oxygen dissociation tests<sup id="cite_ref-:2_12-5" class="reference"><a href="#cite_note-:2-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup></li></ul> <div class="mw-heading mw-heading3"><h3 id="Additional_testing">Additional testing</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Polycythemia&action=edit&section=9" title="Edit section: Additional testing"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Sleep_study" title="Sleep study">Sleep studies</a> if high suspicion for sleep apnea<sup id="cite_ref-:2_12-6" class="reference"><a href="#cite_note-:2-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup></li> <li>Abdominal imaging, such as ultrasound<sup id="cite_ref-:4_5-3" class="reference"><a href="#cite_note-:4-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Erythropoietin_receptor" title="Erythropoietin receptor">Erythropoietin receptor</a> or <a href="/wiki/Von_Hippel%E2%80%93Lindau_tumor_suppressor" title="Von Hippel–Lindau tumor suppressor">von Hippel–Lindau</a> (VHL) genetic testing, if high suspicion for familial erythrocytosis<sup id="cite_ref-:4_5-4" class="reference"><a href="#cite_note-:4-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup></li> <li>Hemoglobin (globin-gene) sequencing or <a href="/wiki/High-performance_liquid_chromatography" title="High-performance liquid chromatography">high-performance liquid chromatography</a> to evaluate for high-affinity hemoglobin variants<sup id="cite_ref-:2_12-7" class="reference"><a href="#cite_note-:2-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Bone_marrow_examination" title="Bone marrow examination">Bone marrow biopsy</a> might be considered in specific cases<sup id="cite_ref-:4_5-5" class="reference"><a href="#cite_note-:4-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup></li></ul> <div class="mw-heading mw-heading2"><h2 id="Absolute_polycythemia">Absolute polycythemia</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Polycythemia&action=edit&section=10" title="Edit section: Absolute polycythemia"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Primary_polycythemia">Primary polycythemia</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Polycythemia&action=edit&section=11" title="Edit section: Primary polycythemia"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Polycythemia_vera" title="Polycythemia vera">Polycythemia vera</a></div> <p>Primary polycythemias are <a href="/wiki/Myeloproliferative_disease" class="mw-redirect" title="Myeloproliferative disease">myeloproliferative diseases</a> affecting red blood cell precursors in the bone marrow. <a href="/wiki/Polycythemia_vera" title="Polycythemia vera">Polycythemia vera</a> (PCV) (a.k.a. polycythemia rubra vera (PRV)) occurs when excess red blood cells are produced as a result of an abnormality of the <a href="/wiki/Bone_marrow" title="Bone marrow">bone marrow</a>.<sup id="cite_ref-:9_3-2" class="reference"><a href="#cite_note-:9-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> Often, excess <a href="/wiki/White_blood_cell" title="White blood cell">white blood cells</a> and <a href="/wiki/Platelet" title="Platelet">platelets</a> are also produced. A hallmark of polycythemia vera is an elevated hematocrit, with Hct > 55% seen in 83% of cases.<sup id="cite_ref-19" class="reference"><a href="#cite_note-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> A <a href="/wiki/Somatic_mutation" title="Somatic mutation">somatic (non-hereditary) mutation</a> (V617F) in the <i><a href="/wiki/Janus_kinase_2" title="Janus kinase 2">JAK2</a></i> gene, also present in other myeloproliferative disorders, is found in 95% of cases.<sup id="cite_ref-20" class="reference"><a href="#cite_note-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup> Symptoms include headaches and <a href="/wiki/Vertigo_(medical)" class="mw-redirect" title="Vertigo (medical)">vertigo</a>, and signs on physical examination include an abnormally <a href="/wiki/Splenomegaly" title="Splenomegaly">enlarged spleen</a> and/or <a href="/wiki/Hepatomegaly" title="Hepatomegaly">liver</a>. Studies suggest that mean arterial pressure (MAP) only increases when hematocrit levels are 20% over baseline. When hematocrit levels are lower than that percentage, the MAP decreases in response, which may be due, in part, to the increase in viscosity and the decrease in plasma layer width. <sup id="cite_ref-21" class="reference"><a href="#cite_note-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup> Furthermore, affected individuals may have other associated conditions alongside <a href="/wiki/Hypertension" title="Hypertension">high blood pressure</a>, including <a href="/wiki/Thrombosis" title="Thrombosis">formation of blood clots</a>. Transformation to acute <a href="/wiki/Leukemia" title="Leukemia">leukemia</a> is rare. <a href="/wiki/Phlebotomy" title="Phlebotomy">Phlebotomy</a> is the mainstay of treatment.<sup id="cite_ref-22" class="reference"><a href="#cite_note-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> </p><p>Primary familial polycythemia, also known as primary familial and congenital polycythemia (PFCP), exists as a benign hereditary condition, in contrast with the myeloproliferative changes associated with acquired PCV. In many families, PFCP is due to an <a href="/wiki/Autosomal_dominant" class="mw-redirect" title="Autosomal dominant">autosomal dominant</a> mutation in the <i>EPOR</i> <a href="/wiki/Erythropoietin_receptor" title="Erythropoietin receptor">erythropoietin receptor</a> gene.<sup id="cite_ref-23" class="reference"><a href="#cite_note-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> PFCP can cause an increase of up to 50% in the oxygen-carrying capacity of the blood; <a href="/wiki/Skier" class="mw-redirect" title="Skier">skier</a> <a href="/wiki/Eero_M%C3%A4ntyranta" title="Eero Mäntyranta">Eero Mäntyranta</a> had PFCP, which is speculated to have given him an advantage in endurance events.<sup id="cite_ref-24" class="reference"><a href="#cite_note-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Secondary_polycythemia">Secondary polycythemia</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Polycythemia&action=edit&section=12" title="Edit section: Secondary polycythemia"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Secondary polycythemia is caused by either natural or artificial increases in the production of <a href="/wiki/Erythropoietin" title="Erythropoietin">erythropoietin</a>, hence an increased production of erythrocytes. </p><p>Secondary polycythemia in which the production of erythropoietin increases appropriately is called <b>physiologic polycythemia.</b> Conditions which may result in physiologic polycythemia include: </p> <ul><li>Altitude related – Polycythemia can be a normal adaptation to living at high altitudes (see <a href="/wiki/Altitude_sickness" title="Altitude sickness">altitude sickness</a>).<sup id="cite_ref-:0_9-1" class="reference"><a href="#cite_note-:0-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> Many athletes train at high altitude to take advantage of this effect, which can be considered a legal form of blood doping, although the efficacy of this strategy is unclear.<sup id="cite_ref-25" class="reference"><a href="#cite_note-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup></li> <li>Hypoxic disease-associated – for example, in cyanotic heart disease where blood oxygen levels are reduced significantly; in hypoxic lung disease such as <a href="/wiki/COPD" class="mw-redirect" title="COPD">COPD</a>; in chronic obstructive <a href="/wiki/Sleep_apnea" title="Sleep apnea">sleep apnea</a>;<sup id="cite_ref-:0_9-2" class="reference"><a href="#cite_note-:0-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> conditions that reduce blood flow to the kidney e.g. renal artery stenosis. Chronic <a href="/wiki/Carbon_monoxide_poisoning" title="Carbon monoxide poisoning">carbon monoxide poisoning</a> (which can be present in heavy smokers) and rarely <a href="/wiki/Methemoglobinemia" title="Methemoglobinemia">methemoglobinemia</a> can also impair oxygen delivery.<sup id="cite_ref-26" class="reference"><a href="#cite_note-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-:5_4-3" class="reference"><a href="#cite_note-:5-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup></li> <li>Genetic – Heritable causes of secondary polycythemia include abnormalities in hemoglobin oxygen release, which results in a greater inherent affinity for oxygen than normal adult hemoglobin and reduces oxygen delivery to tissues.<sup id="cite_ref-27" class="reference"><a href="#cite_note-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup></li></ul> <p>Conditions where the secondary polycythemia is not caused by physiologic adaptation, and occurs irrespective of body needs include:<sup id="cite_ref-:5_4-4" class="reference"><a href="#cite_note-:5-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> </p> <ul><li>Neoplasms – <a href="/wiki/Renal_cell_carcinoma" title="Renal cell carcinoma">Renal cell carcinoma</a>, <a href="/wiki/Liver_tumor" title="Liver tumor">liver tumors</a>, <a href="/wiki/Von_Hippel%E2%80%93Lindau_disease" title="Von Hippel–Lindau disease">Von Hippel–Lindau disease</a>, and endocrine abnormalities including <a href="/wiki/Pheochromocytoma" title="Pheochromocytoma">pheochromocytoma</a> and <a href="/wiki/Adrenal_adenoma" class="mw-redirect" title="Adrenal adenoma">adrenal adenoma</a> with <a href="/wiki/Cushing%27s_syndrome" title="Cushing's syndrome">Cushing's syndrome</a>.</li> <li><a href="/wiki/Anabolic_steroid" title="Anabolic steroid">Anabolic steroid</a> use – people whose testosterone levels are high, including athletes who abuse steroids, people on testosterone replacement for <a href="/wiki/Hypogonadism" title="Hypogonadism">hypogonadism</a> or <a href="/wiki/Transgender" title="Transgender">transgender</a> <a href="/wiki/Hormone_replacement_therapy" title="Hormone replacement therapy">hormone replacement therapy</a>.<sup id="cite_ref-:10_17-1" class="reference"><a href="#cite_note-:10-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup></li> <li>Blood doping – Athletes who take erythropoietin-stimulating agents or receive blood transfusions to increase their red blood cell mass.<sup id="cite_ref-Blood_doping_28-0" class="reference"><a href="#cite_note-Blood_doping-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup></li> <li>Post-transplant erythrocytosis – About 10–15% of patients after renal transplantation are found to have polycythemia at 24 months after transplantation, which can be associated with increased thrombotic (clotting) risk. <sup id="cite_ref-:6_29-0" class="reference"><a href="#cite_note-:6-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup></li></ul> <div class="mw-heading mw-heading4"><h4 id="Altered_oxygen_sensing">Altered oxygen sensing</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Polycythemia&action=edit&section=13" title="Edit section: Altered oxygen sensing"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Rare inherited mutations in three genes which all result in increased stability of <a href="/wiki/Hypoxia-inducible_factors" class="mw-redirect" title="Hypoxia-inducible factors">hypoxia-inducible factors</a>, leading to increased erythropoietin production, have been shown to cause secondary polycythemia: </p> <ul><li><b><a href="/wiki/Chuvash_people" title="Chuvash people">Chuvash</a> erythrocytosis</b> or Chuvash polycythemia is an <a href="/wiki/Autosomal_recessive" class="mw-redirect" title="Autosomal recessive">autosomal recessive</a> form of erythrocytosis endemic in patients from the <a href="/wiki/Chuvashia" title="Chuvashia">Chuvash Republic</a> in Russia. Chuvash erythrocytosis is associated with homozygosity for a C598T mutation in the <a href="/wiki/Von_Hippel%E2%80%93Lindau" class="mw-redirect" title="Von Hippel–Lindau">von Hippel–Lindau</a> gene (<i><a href="/wiki/VHL" class="mw-redirect" title="VHL">VHL</a></i>), which is needed for the destruction of <a href="/wiki/Hypoxia-inducible_factors" class="mw-redirect" title="Hypoxia-inducible factors">hypoxia-inducible factors</a> in the presence of oxygen.<sup id="cite_ref-:8_16-1" class="reference"><a href="#cite_note-:8-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> Clusters of patients with Chuvash erythrocytosis have been found in other populations, such as on the Italian island of <a href="/wiki/Ischia" title="Ischia">Ischia</a>, located in the Bay of Naples.<sup id="cite_ref-:7_15-1" class="reference"><a href="#cite_note-:7-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> Patients with Chuvash erythrocytosis experience a significantly elevated risk of events.<sup id="cite_ref-:11_6-1" class="reference"><a href="#cite_note-:11-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup></li> <li><b>PHD2 erythrocytosis:</b> <a href="/wiki/Heterozygosity" class="mw-redirect" title="Heterozygosity">Heterozygosity</a> for loss-of-function mutations of the <i><a href="/wiki/EGLN1" title="EGLN1">PHD2</a></i> gene are associated with <a href="/wiki/Autosomal_dominant" class="mw-redirect" title="Autosomal dominant">autosomal dominant</a> erythrocytosis and increased hypoxia-inducible factors activity.<sup id="cite_ref-30" class="reference"><a href="#cite_note-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-31" class="reference"><a href="#cite_note-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup></li> <li><b>HIF2α erythrocytosis:</b> Gain-of-function mutations in<i> <a href="/wiki/EPAS1" title="EPAS1">HIF2α</a> </i>are associated with autosomal dominant erythrocytosis<sup id="cite_ref-32" class="reference"><a href="#cite_note-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> and <a href="/wiki/Pulmonary_hypertension" title="Pulmonary hypertension">pulmonary hypertension</a>.<sup id="cite_ref-33" class="reference"><a href="#cite_note-33"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup></li></ul> <div class="mw-heading mw-heading2"><h2 id="Symptoms">Symptoms</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Polycythemia&action=edit&section=14" title="Edit section: Symptoms"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Polycythemia is often asymptomatic; patients may not experience any notable symptoms until their red cell count is very high. For patients with significant elevations in hemoglobin or hematocrit (often from polycythemia vera), some non-specific symptoms include:<sup id="cite_ref-:0_9-3" class="reference"><a href="#cite_note-:0-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p> <ul><li>A ruddy (red) complexion, or plethora<sup id="cite_ref-:2_12-8" class="reference"><a href="#cite_note-:2-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Headache" title="Headache">Headache</a>, transient blurry vision (<a href="/wiki/Amaurosis_fugax" title="Amaurosis fugax">amaurosis fugax</a>), other signs of a <a href="/wiki/Transient_ischemic_attack" title="Transient ischemic attack">transient ischemic attack</a> (TIA) or stroke</li> <li>Dizziness, fatigue</li> <li>Unusual bleeding, nosebleeds</li> <li>Pain in abdomen from enlarged spleen in polycythemia vera</li> <li>Pain in hands and feet (<a href="/wiki/Erythromelalgia" title="Erythromelalgia">erythromelalgia</a>)</li> <li>Itchiness, especially after a hot shower (<a href="/wiki/Aquagenic_pruritus" title="Aquagenic pruritus">aquagenic pruritis</a>)</li> <li>Numbness or tingling in different body parts<sup id="cite_ref-34" class="reference"><a href="#cite_note-34"><span class="cite-bracket">[</span>34<span class="cite-bracket">]</span></a></sup></li></ul> <div class="mw-heading mw-heading2"><h2 id="Epidemiology">Epidemiology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Polycythemia&action=edit&section=15" title="Edit section: Epidemiology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The prevalence of primary polycythemia (polycythemia vera) was estimated to be approximately 44–57 per 100,000 individuals in the United States.<sup id="cite_ref-:6_29-1" class="reference"><a href="#cite_note-:6-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup> Secondary polycythemia is considered to be more common, but its exact prevalence is unknown.<sup id="cite_ref-:6_29-2" class="reference"><a href="#cite_note-:6-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup> In one study using the <a href="/wiki/National_Health_and_Nutrition_Examination_Survey" title="National Health and Nutrition Examination Survey">NHANES</a> dataset, the prevalence of unexplained erythrocytosis is 35.1 per 100,000, and was higher among males and among individuals between ages 50–59 and 60–69.<sup id="cite_ref-35" class="reference"><a href="#cite_note-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Management">Management</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Polycythemia&action=edit&section=16" title="Edit section: Management"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The management of polycythemia varies based on its etiology: </p> <ul><li>See <a href="/wiki/Polycythemia_vera" title="Polycythemia vera">polycythemia vera</a> for management of primary polycythemia, which involves reducing thrombotic risk, symptom amelioration and monitoring for further hematologic complications. Treatment can include phlebotomy, aspirin, and <a href="/wiki/Myelosuppressive" class="mw-redirect" title="Myelosuppressive">myelosuppressive</a> or cytoreductive medications based on risk stratification.<sup id="cite_ref-:3_7-2" class="reference"><a href="#cite_note-:3-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup></li> <li>For secondary polycythemia, management involves addressing the underlying etiology of increased erythropoeitin production, such as smoking cessation, CPAP for sleep apnea, or removing any EPO-producing tumours.<sup id="cite_ref-:11_6-2" class="reference"><a href="#cite_note-:11-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> Phlebotomy is not typically recommended for patients with physiologic polycythemia, who rely on additional red cell mass for necessary oxygen delivery, unless the patient is clearly symptomatic and experiences relief from phlebotomy.<sup id="cite_ref-:11_6-3" class="reference"><a href="#cite_note-:11-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> It is unclear if patients with secondary polycythemia are at elevated thrombotic risk, but aspirin can be considered for patients at elevated cardiovascular risk or for patients with Chuvash polycythemia.<sup id="cite_ref-:11_6-4" class="reference"><a href="#cite_note-:11-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> The first-line treatment for post-transplant erythrocytosis specificity is <a href="/wiki/ACE_inhibitor" title="ACE inhibitor">angiotensin-converting enzyme (ACE) inhibitors</a> or <a href="/wiki/Angiotensin_II_receptor_blocker" title="Angiotensin II receptor blocker">angiotensin receptor blockers</a>.<sup id="cite_ref-:6_29-3" class="reference"><a href="#cite_note-:6-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup></li></ul> <div class="mw-heading mw-heading3"><h3 id="Relation_to_athletic_performance">Relation to athletic performance</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Polycythemia&action=edit&section=17" title="Edit section: Relation to athletic performance"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Polycythemia is theorized to increased performance in <a href="/wiki/Endurance_sport" class="mw-redirect" title="Endurance sport">endurance sports</a> due to the blood being able to store more oxygen.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (December 2020)">citation needed</span></a></i>]</sup> This idea has led to the illegal use of blood doping and transfusions among professional athletes, as well as use of altitude training or elevation training masks to simulate a low-oxygen environment. However, the benefits of altitude training for athletes to improve sea-level performance are not universally accepted, with one reason being athletes at altitude might exert less power during training.<sup id="cite_ref-36" class="reference"><a href="#cite_note-36"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Polycythemia&action=edit&section=18" title="Edit section: See also"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Anemia" title="Anemia">Anemia</a>, a decrease in red blood cell count</li> <li><a href="/wiki/Cytopenia" title="Cytopenia">Cytopenia</a>, a decrease in blood cell count</li> <li><a href="/wiki/Capillary_leak_syndrome" title="Capillary leak syndrome">Capillary leak syndrome</a>, another cause of <a href="/wiki/Hemoconcentration#Elevated" class="mw-redirect" title="Hemoconcentration">hemoconcentration</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Polycythemia&action=edit&section=19" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-1"><span class="mw-cite-backlink"><b><a href="#cite_ref-1">^</a></b></span> <span class="reference-text"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20090628224336/http://www.mercksource.com/pp/us/cns/cns_hl_dorlands_split.jsp?pg=/ppdocs/us/common/dorlands/dorland/six/000084902.htm">"Absolute polycythemia"</a> at <i><a href="/wiki/Dorland%27s_medical_reference_works" title="Dorland's medical reference works">Dorland's Medical Dictionary</a></i></span> </li> <li id="cite_note-2"><span class="mw-cite-backlink"><b><a href="#cite_ref-2">^</a></b></span> <span class="reference-text"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20090628224336/http://www.mercksource.com/pp/us/cns/cns_hl_dorlands_split.jsp?pg=/ppdocs/us/common/dorlands/dorland/six/000084909.htm">"Relative polycythemia"</a> at <i><a href="/wiki/Dorland%27s_medical_reference_works" title="Dorland's medical reference works">Dorland's Medical Dictionary</a></i></span> </li> <li id="cite_note-:9-3"><span class="mw-cite-backlink">^ <a href="#cite_ref-:9_3-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:9_3-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-:9_3-2"><sup><i><b>c</b></i></sup></a></span> <span class="reference-text"><i><a href="/wiki/MedlinePlus" title="MedlinePlus">MedlinePlus Encyclopedia</a></i>: <a rel="nofollow" class="external text" href="https://medlineplus.gov/ency/article/000589.htm">Polycythemia vera</a></span> </li> <li id="cite_note-:5-4"><span class="mw-cite-backlink">^ <a href="#cite_ref-:5_4-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:5_4-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-:5_4-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-:5_4-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-:5_4-4"><sup><i><b>e</b></i></sup></a></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite id="CITEREFMithoowaniLaureanoCrowtherHillis2020" class="citation journal cs1">Mithoowani S, Laureano M, Crowther MA, Hillis CM (August 2020). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7829024">"Investigation and management of erythrocytosis"</a>. <i>CMAJ</i>. <b>192</b> (32): E913–E918. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1503%2Fcmaj.191587">10.1503/cmaj.191587</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7829024">7829024</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/32778603">32778603</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=CMAJ&rft.atitle=Investigation+and+management+of+erythrocytosis&rft.volume=192&rft.issue=32&rft.pages=E913-E918&rft.date=2020-08&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC7829024%23id-name%3DPMC&rft_id=info%3Apmid%2F32778603&rft_id=info%3Adoi%2F10.1503%2Fcmaj.191587&rft.aulast=Mithoowani&rft.aufirst=S&rft.au=Laureano%2C+M&rft.au=Crowther%2C+MA&rft.au=Hillis%2C+CM&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC7829024&rfr_id=info%3Asid%2Fen.wikipedia.org%3APolycythemia" class="Z3988"></span></span> </li> <li id="cite_note-:4-5"><span class="mw-cite-backlink">^ <a href="#cite_ref-:4_5-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:4_5-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-:4_5-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-:4_5-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-:4_5-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-:4_5-5"><sup><i><b>f</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFMcMullinBarefordCampbellGreen2005" class="citation journal cs1">McMullin MF, Bareford D, Campbell P, Green AR, Harrison C, Hunt B, et al. 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title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+New+England+Journal+of+Medicine&rft.atitle=A+gain-of-function+mutation+in+the+HIF2A+gene+in+familial+erythrocytosis&rft.volume=358&rft.issue=2&rft.pages=162-168&rft.date=2008-01&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2295209%23id-name%3DPMC&rft_id=info%3Apmid%2F18184961&rft_id=info%3Adoi%2F10.1056%2FNEJMoa073123&rft.aulast=Percy&rft.aufirst=MJ&rft.au=Furlow%2C+PW&rft.au=Lucas%2C+GS&rft.au=Li%2C+X&rft.au=Lappin%2C+TR&rft.au=McMullin%2C+MF&rft.au=Lee%2C+FS&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2295209&rfr_id=info%3Asid%2Fen.wikipedia.org%3APolycythemia" class="Z3988"></span></span> </li> <li id="cite_note-33"><span class="mw-cite-backlink"><b><a href="#cite_ref-33">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFGaleHartenReidTuddenham2008" class="citation journal cs1">Gale DP, Harten SK, Reid CD, Tuddenham EG, Maxwell PH (August 2008). <a rel="nofollow" class="external text" href="https://doi.org/10.1182%2Fblood-2008-04-153718">"Autosomal dominant erythrocytosis and pulmonary arterial hypertension associated with an activating HIF2 alpha mutation"</a>. <i>Blood</i>. <b>112</b> (3): 919–921. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1182%2Fblood-2008-04-153718">10.1182/blood-2008-04-153718</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/18650473">18650473</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:14580718">14580718</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Blood&rft.atitle=Autosomal+dominant+erythrocytosis+and+pulmonary+arterial+hypertension+associated+with+an+activating+HIF2+alpha+mutation&rft.volume=112&rft.issue=3&rft.pages=919-921&rft.date=2008-08&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A14580718%23id-name%3DS2CID&rft_id=info%3Apmid%2F18650473&rft_id=info%3Adoi%2F10.1182%2Fblood-2008-04-153718&rft.aulast=Gale&rft.aufirst=DP&rft.au=Harten%2C+SK&rft.au=Reid%2C+CD&rft.au=Tuddenham%2C+EG&rft.au=Maxwell%2C+PH&rft_id=https%3A%2F%2Fdoi.org%2F10.1182%252Fblood-2008-04-153718&rfr_id=info%3Asid%2Fen.wikipedia.org%3APolycythemia" class="Z3988"></span></span> </li> <li id="cite_note-34"><span class="mw-cite-backlink"><b><a href="#cite_ref-34">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.mayoclinic.org/diseases-conditions/polycythemia-vera/symptoms-causes/syc-20355850">"Polycythemia Vera"</a>. <i>Mayo Clinic</i>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Mayo+Clinic&rft.atitle=Polycythemia+Vera&rft_id=https%3A%2F%2Fwww.mayoclinic.org%2Fdiseases-conditions%2Fpolycythemia-vera%2Fsymptoms-causes%2Fsyc-20355850&rfr_id=info%3Asid%2Fen.wikipedia.org%3APolycythemia" class="Z3988"></span></span> </li> <li id="cite_note-35"><span class="mw-cite-backlink"><b><a href="#cite_ref-35">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFTremblayAlpertTaioliMascarenhas2021" class="citation journal cs1">Tremblay D, Alpert N, Taioli E, Mascarenhas J (August 2021). "Prevalence of unexplained erythrocytosis and thrombocytosis - an NHANES analysis". <i>Leukemia & Lymphoma</i>. <b>62</b> (8): 2030–2033. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1080%2F10428194.2021.1888377">10.1080/10428194.2021.1888377</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/33645402">33645402</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:232078345">232078345</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Leukemia+%26+Lymphoma&rft.atitle=Prevalence+of+unexplained+erythrocytosis+and+thrombocytosis+-+an+NHANES+analysis&rft.volume=62&rft.issue=8&rft.pages=2030-2033&rft.date=2021-08&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A232078345%23id-name%3DS2CID&rft_id=info%3Apmid%2F33645402&rft_id=info%3Adoi%2F10.1080%2F10428194.2021.1888377&rft.aulast=Tremblay&rft.aufirst=D&rft.au=Alpert%2C+N&rft.au=Taioli%2C+E&rft.au=Mascarenhas%2C+J&rfr_id=info%3Asid%2Fen.wikipedia.org%3APolycythemia" class="Z3988"></span></span> </li> <li id="cite_note-36"><span class="mw-cite-backlink"><b><a href="#cite_ref-36">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFFulcoRockCymerman2000" class="citation journal cs1">Fulco, C. S.; Rock, P. B.; Cymerman, A. (2000). <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/10685591">"Improving athletic performance: is altitude residence or altitude training helpful?"</a>. <i>Aviation, Space, and Environmental Medicine</i>. <b>71</b> (2): 162–171. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/0095-6562">0095-6562</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/10685591">10685591</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Aviation%2C+Space%2C+and+Environmental+Medicine&rft.atitle=Improving+athletic+performance%3A+is+altitude+residence+or+altitude+training+helpful%3F&rft.volume=71&rft.issue=2&rft.pages=162-171&rft.date=2000&rft_id=info%3Apmid%2F10685591&rft.issn=0095-6562&rft.aulast=Fulco&rft.aufirst=C.+S.&rft.au=Rock%2C+P.+B.&rft.au=Cymerman%2C+A.&rft_id=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F10685591&rfr_id=info%3Asid%2Fen.wikipedia.org%3APolycythemia" class="Z3988"></span></span> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Polycythemia&action=edit&section=20" title="Edit section: External links"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="navbox-styles"><style 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dd:last-child::after,.mw-parser-output .hlist li dt:last-child::after,.mw-parser-output .hlist li li:last-child::after{content:")";font-weight:normal}.mw-parser-output .hlist ol{counter-reset:listitem}.mw-parser-output .hlist ol>li{counter-increment:listitem}.mw-parser-output .hlist ol>li::before{content:" "counter(listitem)"\a0 "}.mw-parser-output .hlist dd ol>li:first-child::before,.mw-parser-output .hlist dt ol>li:first-child::before,.mw-parser-output .hlist li ol>li:first-child::before{content:" ("counter(listitem)"\a0 "}</style><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"></div><div role="navigation" class="navbox" aria-label="Navbox" style="width:100%; margin:0.5em 0 0.5em 0;;padding:3px"><table class="nowraplinks navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q933716" class="extiw" title="d:Q933716">D</a></div><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-11" title="ICD-11">11</a></b>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse/latest-release/mms/en#1617675057">3A80</a>, <a rel="nofollow" class="external text" href="https://icd.who.int/browse/latest-release/mms/en#1159594433">3A81</a>, <a rel="nofollow" class="external text" href="https://icd.who.int/browse/latest-release/mms/en#818364947">2A20.4</a>, <a rel="nofollow" class="external text" href="https://icd.who.int/browse/latest-release/mms/en#819483525">KA8A</a></li><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-10" title="ICD-10">10</a></b>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/D75.1">D75.1</a>, <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/P61.1">P61.1</a></li><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/List_of_ICD-9_codes" title="List of ICD-9 codes">9-CM</a></b>: <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=289.0">289.0</a>, <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=776.4">776.4</a></li><li><b><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a></b>: <a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D011086">D011086</a></li><li><b><a href="/wiki/Diseases_Database" title="Diseases Database">DiseasesDB</a></b>: <a rel="nofollow" class="external text" href="http://www.diseasesdatabase.com/ddb10295.htm">10295</a></li></ul></div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">External resources</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/EMedicine" title="EMedicine">eMedicine</a></b>: <a rel="nofollow" class="external text" href="https://emedicine.medscape.com/Ped/1848-overview">Ped/1848</a></li><li><b><a href="/wiki/Orphanet" title="Orphanet">Orphanet</a></b>: <a rel="nofollow" class="external text" href="https://www.orpha.net/consor/cgi-bin/OC_Exp.php?lng=en&Expert=729">729</a></li></ul></div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Diseases_of_red_blood_cells" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><style data-mw-deduplicate="TemplateStyles:r1239400231">.mw-parser-output .navbar{display:inline;font-size:88%;font-weight:normal}.mw-parser-output .navbar-collapse{float:left;text-align:left}.mw-parser-output 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navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Diseases_of_RBCs" title="Template:Diseases of RBCs"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Diseases_of_RBCs" title="Template talk:Diseases of RBCs"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Diseases_of_RBCs" title="Special:EditPage/Template:Diseases of RBCs"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Diseases_of_red_blood_cells" style="font-size:114%;margin:0 4em"><a href="/wiki/Hematologic_disease" title="Hematologic disease">Diseases</a> of <a href="/wiki/Red_blood_cell" title="Red blood cell">red blood cells</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">↑</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th id="Polycythemia" scope="row" class="navbox-group" style="width:1%"><a class="mw-selflink selflink">Polycythemia</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Polycythemia_vera" title="Polycythemia vera">Polycythemia vera</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">↓</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th id="Anemia" scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Anemia" title="Anemia">Anemia</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Nutritional_anemia" title="Nutritional anemia">Nutritional</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Microcytic_anemia" title="Microcytic anemia">Micro-</a>: <a href="/wiki/Iron-deficiency_anemia" title="Iron-deficiency anemia">Iron-deficiency anemia</a> <ul><li><a href="/wiki/Plummer%E2%80%93Vinson_syndrome" title="Plummer–Vinson syndrome">Plummer–Vinson syndrome</a></li></ul></li></ul> <ul><li><a href="/wiki/Macrocytic_anemia" title="Macrocytic anemia">Macro-</a>: <a href="/wiki/Megaloblastic_anemia" title="Megaloblastic anemia">Megaloblastic anemia</a> <ul><li><a href="/wiki/Pernicious_anemia" title="Pernicious anemia">Pernicious anemia</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Hemolytic_anemia" title="Hemolytic anemia">Hemolytic</a><br />(mostly <a href="/wiki/Normocytic_anemia" title="Normocytic anemia">normo-</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Congenital_hemolytic_anemia" title="Congenital hemolytic anemia">Hereditary</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Enzymopathy" class="mw-redirect" title="Enzymopathy">enzymopathy</a>:</i> <a href="/wiki/Glucose-6-phosphate_dehydrogenase_deficiency" title="Glucose-6-phosphate dehydrogenase deficiency">Glucose-6-phosphate dehydrogenase deficiency</a></li> <li><i><a href="/wiki/Glycolysis" title="Glycolysis">glycolysis</a></i> <ul><li><a href="/wiki/Pyruvate_kinase_deficiency" title="Pyruvate kinase deficiency">pyruvate kinase deficiency</a></li> <li><a href="/wiki/Triosephosphate_isomerase_deficiency" title="Triosephosphate isomerase deficiency">triosephosphate isomerase deficiency</a></li> <li><a href="/wiki/Hexokinase_deficiency" title="Hexokinase deficiency">hexokinase deficiency</a></li></ul></li></ul> <ul><li><i><a href="/wiki/Hemoglobinopathy" title="Hemoglobinopathy">hemoglobinopathy</a>:</i> <a href="/wiki/Thalassemia" title="Thalassemia">Thalassemia</a> <ul><li><a href="/wiki/Alpha-thalassemia" title="Alpha-thalassemia">alpha</a></li> <li><a href="/wiki/Beta_thalassemia" title="Beta thalassemia">beta</a></li> <li><a href="/wiki/Delta-thalassemia" class="mw-redirect" title="Delta-thalassemia">delta</a></li></ul></li> <li><a href="/wiki/Sickle_cell_disease" title="Sickle cell disease">Sickle cell disease</a>/<a href="/wiki/Sickle_cell_trait" title="Sickle cell trait">trait</a></li> <li><a href="/wiki/Hemoglobin_C_disease" class="mw-redirect" title="Hemoglobin C disease">Hemoglobin C disease</a></li> <li><i><a href="/wiki/Red_blood_cell#Membranes_and_surface_proteins" title="Red blood cell">membrane</a>:</i> <a href="/wiki/Hereditary_spherocytosis" title="Hereditary spherocytosis">Hereditary spherocytosis</a> <ul><li><a href="/wiki/Minkowski%E2%80%93Chauffard_syndrome" class="mw-redirect" title="Minkowski–Chauffard syndrome">Minkowski–Chauffard syndrome</a></li></ul></li> <li><a href="/wiki/Hereditary_elliptocytosis" title="Hereditary elliptocytosis">Hereditary elliptocytosis</a> <ul><li><a href="/wiki/Southeast_Asian_ovalocytosis" title="Southeast Asian ovalocytosis">Southeast Asian ovalocytosis</a></li></ul></li> <li><a href="/wiki/Hereditary_stomatocytosis" title="Hereditary stomatocytosis">Hereditary stomatocytosis</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Acquired_hemolytic_anemia" title="Acquired hemolytic anemia">Acquired</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th id="AIHA" scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Autoimmune_hemolytic_anemia" title="Autoimmune hemolytic anemia">AIHA</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Warm_antibody_autoimmune_hemolytic_anemia" title="Warm antibody autoimmune hemolytic anemia">Warm antibody autoimmune hemolytic anemia</a></li> <li><a href="/wiki/Cold_agglutinin_disease" title="Cold agglutinin disease">Cold agglutinin disease</a></li> <li><a href="/wiki/Donath%E2%80%93Landsteiner_hemolytic_anemia" class="mw-redirect" title="Donath–Landsteiner hemolytic anemia">Donath–Landsteiner hemolytic anemia</a> <ul><li><a href="/wiki/Paroxysmal_cold_hemoglobinuria" title="Paroxysmal cold hemoglobinuria">Paroxysmal cold hemoglobinuria</a></li></ul></li> <li><a href="/wiki/Mixed_autoimmune_hemolytic_anemia" title="Mixed autoimmune hemolytic anemia">Mixed autoimmune hemolytic anemia</a></li></ul> </div></td></tr></tbody></table><div> <ul><li><i><a href="/wiki/Red_blood_cell#Membranes_and_surface_proteins" title="Red blood cell">membrane</a></i> <ul><li><a href="/wiki/Paroxysmal_nocturnal_hemoglobinuria" title="Paroxysmal nocturnal hemoglobinuria">paroxysmal nocturnal hemoglobinuria</a></li></ul></li></ul> <ul><li><a href="/wiki/Microangiopathic_hemolytic_anemia" title="Microangiopathic hemolytic anemia">Microangiopathic hemolytic anemia</a></li> <li><a href="/wiki/Thrombotic_microangiopathy" title="Thrombotic microangiopathy">Thrombotic microangiopathy</a> <ul><li><a href="/wiki/Hemolytic%E2%80%93uremic_syndrome" title="Hemolytic–uremic syndrome">Hemolytic–uremic syndrome</a></li></ul></li></ul> <ul><li><a href="/wiki/Drug-induced_autoimmune_hemolytic_anemia" title="Drug-induced autoimmune hemolytic anemia">Drug-induced autoimmune</a></li> <li><a href="/wiki/Drug-induced_nonautoimmune_hemolytic_anemia" title="Drug-induced nonautoimmune hemolytic anemia">Drug-induced nonautoimmune</a></li></ul> <ul><li><a href="/wiki/Hemolytic_disease_of_the_newborn" title="Hemolytic disease of the newborn">Hemolytic disease of the newborn</a></li></ul></div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Aplastic_anemia" title="Aplastic anemia">Aplastic</a><br />(mostly <a href="/wiki/Normocytic_anemia" title="Normocytic anemia">normo-</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <li><a href="/wiki/Congenital_hypoplastic_anemia" title="Congenital hypoplastic anemia">Hereditary</a>: <a href="/wiki/Fanconi_anemia" title="Fanconi anemia">Fanconi anemia</a></li> <li><a href="/wiki/Diamond%E2%80%93Blackfan_anemia" title="Diamond–Blackfan anemia">Diamond–Blackfan anemia</a></li> <ul><li>Acquired: <a href="/wiki/Pure_red_cell_aplasia" title="Pure red cell aplasia">Pure red cell aplasia</a></li> <li><a href="/wiki/Sideroblastic_anemia" title="Sideroblastic anemia">Sideroblastic anemia</a></li> <li><a href="/wiki/Myelophthisic_anemia" title="Myelophthisic anemia">Myelophthisic</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Red_blood_cell_indices" title="Red blood cell indices">Blood tests</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Mean_corpuscular_volume" title="Mean corpuscular volume">Mean corpuscular volume</a></i> <ul><li><a href="/wiki/Normocytic_anemia" title="Normocytic anemia">normocytic</a></li> <li><a href="/wiki/Microcytic_anemia" title="Microcytic anemia">microcytic</a></li> <li><a href="/wiki/Macrocytic_anemia" title="Macrocytic anemia">macrocytic</a></li></ul></li> <li><i><a href="/wiki/Mean_corpuscular_hemoglobin_concentration" title="Mean corpuscular hemoglobin concentration">Mean corpuscular hemoglobin concentration</a></i> <ul><li><a href="/wiki/Normochromic_anemia" title="Normochromic anemia">normochromic</a></li> <li><a href="/wiki/Hypochromic_anemia" title="Hypochromic anemia">hypochromic</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Methemoglobinemia" title="Methemoglobinemia">Methemoglobinemia</a></li> <li><a href="/wiki/Sulfhemoglobinemia" title="Sulfhemoglobinemia">Sulfhemoglobinemia</a></li> <li><a href="/wiki/Reticulocytopenia" title="Reticulocytopenia">Reticulocytopenia</a></li> <li><a href="/wiki/Hereditary_persistence_of_fetal_hemoglobin" title="Hereditary persistence of fetal hemoglobin">Hereditary persistence of fetal hemoglobin</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Conditions_originating_in_the_perinatal_period_/_fetal_disease" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Pediatric_conditions_originating_in_the_perinatal_period" title="Template:Pediatric conditions originating in the perinatal period"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Pediatric_conditions_originating_in_the_perinatal_period" title="Template talk:Pediatric conditions originating in the perinatal period"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Pediatric_conditions_originating_in_the_perinatal_period" title="Special:EditPage/Template:Pediatric conditions originating in the perinatal period"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Conditions_originating_in_the_perinatal_period_/_fetal_disease" style="font-size:114%;margin:0 4em">Conditions originating in the <a href="/wiki/Perinatal" class="mw-redirect" title="Perinatal">perinatal</a> period / <a href="/wiki/Fetal_disease" class="mw-redirect" title="Fetal disease">fetal disease</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">Maternal factors <br /> complicating pregnancy,<br /> labour or delivery</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><span class="nobold"><i><a href="/wiki/Placental_disease" title="Placental disease">placenta</a></i></span></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Placenta_praevia" title="Placenta praevia">Placenta praevia</a></li> <li><a href="/wiki/Placental_insufficiency" title="Placental insufficiency">Placental insufficiency</a></li> <li><a href="/wiki/Twin-to-twin_transfusion_syndrome" title="Twin-to-twin transfusion syndrome">Twin-to-twin transfusion syndrome</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><span class="nobold"><i><a href="/wiki/Chorion" title="Chorion">chorion</a>/<a href="/wiki/Amnion" title="Amnion">amnion</a></i></span></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Chorioamnionitis" title="Chorioamnionitis">Chorioamnionitis</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><span class="nobold"><i><a href="/wiki/Umbilical_cord#Problems_and_abnormalities" title="Umbilical cord">umbilical cord</a></i></span></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Umbilical_cord_prolapse" title="Umbilical cord prolapse">Umbilical cord prolapse</a></li> <li><a href="/wiki/Nuchal_cord" title="Nuchal cord">Nuchal cord</a></li> <li><a href="/wiki/Single_umbilical_artery" title="Single umbilical artery">Single umbilical artery</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><span class="nobold"><i><a href="/wiki/Presentation_(obstetrics)" title="Presentation (obstetrics)">presentation</a></i></span></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Breech_birth" title="Breech birth">Breech birth</a></li> <li><a href="/wiki/Asynclitic_birth" title="Asynclitic birth">Asynclitism</a></li> <li><a href="/wiki/Shoulder_presentation" title="Shoulder presentation">Shoulder presentation</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Growth</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Small_for_gestational_age" title="Small for gestational age">Small for gestational age</a> / <a href="/wiki/Large_for_gestational_age" title="Large for gestational age">Large for gestational age</a></li> <li><a href="/wiki/Preterm_birth" title="Preterm birth">Preterm birth</a> / <a href="/wiki/Postterm_pregnancy" title="Postterm pregnancy">Postterm pregnancy</a></li> <li><a href="/wiki/Intrauterine_growth_restriction" title="Intrauterine growth restriction">Intrauterine growth restriction</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Birth_trauma_(physical)" title="Birth trauma (physical)">Birth trauma</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Scalp" title="Scalp">scalp</a></i> <ul><li><a href="/wiki/Cephalohematoma" title="Cephalohematoma">Cephalohematoma</a></li> <li><a href="/wiki/Chignon_(medical_term)" title="Chignon (medical term)">Chignon</a></li> <li><a href="/wiki/Caput_succedaneum" title="Caput succedaneum">Caput succedaneum</a></li> <li><a href="/wiki/Subgaleal_hemorrhage" title="Subgaleal hemorrhage">Subgaleal hemorrhage</a></li></ul></li> <li><a href="/wiki/Brachial_plexus_injury" title="Brachial plexus injury">Brachial plexus injury</a> <ul><li><a href="/wiki/Erb%27s_palsy" title="Erb's palsy">Erb's palsy</a></li> <li><a href="/wiki/Klumpke_paralysis" title="Klumpke paralysis">Klumpke paralysis</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Affected systems</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Respiratory_disease" title="Respiratory disease">Respiratory</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Intrauterine_hypoxia" title="Intrauterine hypoxia">Intrauterine hypoxia</a></li> <li><a href="/wiki/Infant_respiratory_distress_syndrome" title="Infant respiratory distress syndrome">Infant respiratory distress syndrome</a></li> <li><a href="/wiki/Transient_tachypnea_of_the_newborn" title="Transient tachypnea of the newborn">Transient tachypnea of the newborn</a></li> <li><a href="/wiki/Meconium_aspiration_syndrome" title="Meconium aspiration syndrome">Meconium aspiration syndrome</a></li> <li><i><a href="/wiki/Pleural_disease" title="Pleural disease">Pleural disease</a></i> <ul><li><a href="/wiki/Pneumothorax" title="Pneumothorax">Pneumothorax</a></li> <li><a href="/wiki/Pneumomediastinum" title="Pneumomediastinum">Pneumomediastinum</a></li></ul></li> <li><a href="/wiki/Wilson%E2%80%93Mikity_syndrome" title="Wilson–Mikity syndrome">Wilson–Mikity syndrome</a></li> <li><a href="/wiki/Bronchopulmonary_dysplasia" title="Bronchopulmonary dysplasia">Bronchopulmonary dysplasia</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Cardiovascular_disease" title="Cardiovascular disease">Cardiovascular</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Pneumopericardium" title="Pneumopericardium">Pneumopericardium</a></li> <li><a href="/wiki/Persistent_fetal_circulation" title="Persistent fetal circulation">Persistent fetal circulation</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Bleeding" title="Bleeding">Bleeding</a> and<br /><a href="/wiki/Hematologic_disease" title="Hematologic disease">hematologic disease</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Vitamin_K_deficiency_bleeding" title="Vitamin K deficiency bleeding">Vitamin K deficiency bleeding</a></li></ul> <ul><li><a href="/wiki/Hemolytic_disease_of_the_newborn" title="Hemolytic disease of the newborn">HDN</a> <ul><li><a href="/wiki/Hemolytic_disease_of_the_newborn_(ABO)" title="Hemolytic disease of the newborn (ABO)">ABO</a></li> <li><a href="/wiki/Hemolytic_disease_of_the_newborn_(anti-Kell)" title="Hemolytic disease of the newborn (anti-Kell)">Anti-Kell</a></li> <li><a href="/wiki/Hemolytic_disease_of_the_newborn_(anti-Rhc)" title="Hemolytic disease of the newborn (anti-Rhc)">Rh c</a></li> <li><a href="/wiki/Rh_disease" title="Rh disease">Rh D</a></li> <li><a href="/wiki/Hemolytic_disease_of_the_newborn_(anti-RhE)" title="Hemolytic disease of the newborn (anti-RhE)">Rh E</a></li></ul></li> <li><a href="/wiki/Hydrops_fetalis" title="Hydrops fetalis">Hydrops fetalis</a></li> <li><a href="/wiki/Hyperbilirubinemia" class="mw-redirect" title="Hyperbilirubinemia">Hyperbilirubinemia</a> <ul><li><a href="/wiki/Kernicterus" title="Kernicterus">Kernicterus</a></li> <li><a href="/wiki/Neonatal_jaundice" title="Neonatal jaundice">Neonatal jaundice</a></li></ul></li></ul> <ul><li><a href="/wiki/Velamentous_cord_insertion" title="Velamentous cord insertion">Velamentous cord insertion</a></li> <li><a href="/wiki/Intraventricular_hemorrhage" title="Intraventricular hemorrhage">Intraventricular hemorrhage</a> <ul><li><a href="/wiki/Germinal_matrix_hemorrhage" title="Germinal matrix hemorrhage">Germinal matrix hemorrhage</a></li></ul></li> <li><a href="/wiki/Anemia_of_prematurity" title="Anemia of prematurity">Anemia of prematurity</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Gastrointestinal_disease" title="Gastrointestinal disease">Gastrointestinal</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Ileus" title="Ileus">Ileus</a></li> <li><a href="/wiki/Necrotizing_enterocolitis" title="Necrotizing enterocolitis">Necrotizing enterocolitis</a></li> <li><a href="/wiki/Meconium_peritonitis" title="Meconium peritonitis">Meconium peritonitis</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Integumentary_system" title="Integumentary system">Integument</a> and<br /><a href="/wiki/Thermoregulation" title="Thermoregulation">thermoregulation</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Erythema_toxicum_neonatorum" title="Erythema toxicum neonatorum">Erythema toxicum</a></li> <li><a href="/wiki/Sclerema_neonatorum" title="Sclerema neonatorum">Sclerema neonatorum</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Nervous_system_disease" title="Nervous system disease">Nervous system</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Perinatal_asphyxia" title="Perinatal asphyxia">Perinatal asphyxia</a></li> <li><a href="/wiki/Periventricular_leukomalacia" title="Periventricular leukomalacia">Periventricular leukomalacia</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Musculoskeletal_disorder" title="Musculoskeletal disorder">Musculoskeletal</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Gray_baby_syndrome" title="Gray baby syndrome">Gray baby syndrome</a></li> <li><i><a href="/wiki/Muscle_tone" title="Muscle tone">muscle tone</a></i> <ul><li><a href="/wiki/Hypertonia" title="Hypertonia">Congenital hypertonia</a></li> <li><a href="/wiki/Hypotonia" title="Hypotonia">Congenital hypotonia</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Infections</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Vertically_transmitted_infection" title="Vertically transmitted infection">Vertically transmitted infection</a></li> <li><a href="/wiki/Neonatal_infection" title="Neonatal infection">Neonatal infection</a> <ul><li><a href="/wiki/Congenital_rubella_syndrome" title="Congenital rubella syndrome">rubella</a></li> <li><a href="/wiki/Neonatal_herpes_simplex" class="mw-redirect" title="Neonatal herpes simplex">herpes simplex</a></li> <li><a href="/wiki/Mycoplasma_hominis_infection" title="Mycoplasma hominis infection">mycoplasma hominis</a></li> <li><a href="/wiki/Ureaplasma_urealyticum_infection" class="mw-redirect" title="Ureaplasma urealyticum infection">ureaplasma urealyticum</a></li></ul></li> <li><a href="/wiki/Omphalitis" class="mw-redirect" title="Omphalitis">Omphalitis</a></li> <li><a href="/wiki/Neonatal_sepsis" title="Neonatal sepsis">Neonatal sepsis</a> <ul><li><a href="/wiki/Group_B_streptococcal_infection" title="Group B streptococcal infection">Group B streptococcal infection</a></li></ul></li> <li><a href="/wiki/Neonatal_conjunctivitis" title="Neonatal conjunctivitis">Neonatal conjunctivitis</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Miscarriage" title="Miscarriage">Miscarriage</a></li> <li><a href="/wiki/Perinatal_mortality" title="Perinatal mortality">Perinatal mortality</a> <ul><li><a href="/wiki/Stillbirth" title="Stillbirth">Stillbirth</a></li> <li><a href="/wiki/Infant_mortality" title="Infant mortality">Infant mortality</a></li></ul></li> <li><a href="/wiki/Neonatal_withdrawal" title="Neonatal withdrawal">Neonatal withdrawal</a></li> <li><a href="/wiki/Fetal_Alcohol_Spectrum_Disorder" class="mw-redirect" title="Fetal Alcohol Spectrum Disorder">Fetal Alcohol Spectrum Disorder</a></li></ul> </div></td></tr></tbody></table></div>    </div><noscript><img src="https://login.wikimedia.org/wiki/Special:CentralAutoLogin/start?type=1x1" alt="" width="1" height="1" style="border: none; position: absolute;"></noscript> <div class="printfooter" data-nosnippet="">Retrieved from "<a dir="ltr" href="https://en.wikipedia.org/w/index.php?title=Polycythemia&oldid=1257887314">https://en.wikipedia.org/w/index.php?title=Polycythemia&oldid=1257887314</a>"</div></div> <div id="catlinks" class="catlinks" data-mw="interface"><div id="mw-normal-catlinks" class="mw-normal-catlinks"><a href="/wiki/Help:Category" title="Help:Category">Categories</a>: <ul><li><a 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