Secondary Erythrocytosis, a Predominant Cause of Polycythemia- Clinical and Laboratory Evaluation of Polycythemia in a Tertiary Care Center

Abstract

Aims: Polycythemia refers to an increased production of red blood cells from bone marrow. It is one of the frequent reasons for a hematology consultation. The present work aimed to examine the causes, clinical manifestations, prevalence, and diverse patterns in laboratory and clinical parameters among patients with polycythemia attending our outpatient clinics at the Indus Hospital and Health Network. Study Design: The present work is retrospective observational study which included all cases of polycythemia. Place and Duration of the Study: The study was conducted at a tertiary health care center in Karachi, Pakistan during October 2019 to July 2021. Methodology: The data from the patient diagnosed with polycythemia was entered and analyzed by using SPSS version 24.0. Descriptive statistics as per the Gaussian Normality distribution (Sapiro-Wilk) were computed along with frequencies. The association where applicable was calculated via standard statistical methods with the chi square test for categorical while independent sample t-test for the continuous variables. The level of statistical significance will be set at P < 0.05. Results: During the investigated period, a total of 33 patients were diagnosed with polycythemia demonstrating a notable male predominance (82%). The majority of the patients exhibited secondary erythrocytosis (85%) with only a minority (15%) diagnosed with polycythemia vera. Of the identified cases of secondary erythrocytosis a significant proportion (46%) was observed in individuals who were smokers while other were found with hypoxic pulmonary disease, hepatitis, and chronic kidney disease. In secondary erythrocytosis 21 patients (75%) required venesection for symptom reduction, while 7 (25%) were closely monitored due to their asymptomatic status. On the contrary all cases of polycythemia vera required a comprehensive treatment approach including venesections, cytoreduction with hydroxyurea and low dose aspirin.