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Male | 67

Am I Dealing with Polycythemia Vera or Secondary Cause?

Dear Doctor, Due to my father's high blood viscosity, suspicion of polycythemia arises, necessitating blood draws every 3 weeks to maintain appropriate levels. At 69 years old, he experiences symptoms such as skin itching, swelling, head numbness, and fatigue. Currently, his JAK2 V617F mutation showed 0.8 then 1.2%, with JAK2 exon 12 negative and EPO at 13.4. Abdominal CT and chest X-ray are normal. After a few months of phlebotomy, his levels normalized. Now, we await the bone marrow biopsy results, which do not confirm Polycythemia Vera: "Microscopic description: The bone marrow biopsy sample shows somewhat hypocellular hematopoietic parenchyma relative to age, which is terminally mature. Myeloid ratio is 2:1 with dominance of late precursors; no blast cells are noted. The number of megakaryocytes is normal with no clustering. There is no interstitial fibrosis or lymphoid infiltrate. Diagnosis: Mature, hypocellular hematopoietic parenchyma without myeloproliferative features. Cytogenetic analysis confirmed male karyotype; no clonal chromosomal abnormalities detected. Indication for examination D7510 Secondary polycythemia Note Submicroscopic rearrangements, small structural chromosomal aberrations, DNA-level differences cannot be ruled out with the method used." I am quite confused as JAK2 positivity typically suggests PV, yet the biopsy suggests otherwise, possibly indicating secondary polycythemia. Could you please clarify based on this information what you personally think is more likely, Polycythemia Vera or another secondary cause? Thank you very much for your help.

1 Answer

Answered on 3rd July '24

Your father's symptoms and test results do suggest some complexity. The presence of JAK2 mutation often points towards Polycythemia Vera (PV), but the bone marrow biopsy does not show typical myeloproliferative features, suggesting it might be secondary polycythemia instead. Consult a hematologist, specializing in blood disorders, and can provide a more accurate diagnosis and appropriate treatment plan.

 

2 people found this helpful

Questions & Answers on "Hematology" (166)

Good day doc, I noticed some traces of blood in my mucur. What could be the possible cause and solution

Male | 29

When you find some blood in mucus, it can indicate several ailments. Possible reasons could be a nosebleed, irritation by dry air, or an infection such as sinusitis. If you are facing a runny nose, pain in your face, or a sore throat, that could be a sign of an infection. Drinking a lot of water, using a humidifier, and visiting a doctor if it persists are the ways to go.

Answered on 18th Sept '24

Dr. Babita Goel

Dr. Babita Goel

Is 3.5 mmol/l cholesterol is normal

Male | 37

When you have 3.5 mmol/l cholesterol, that is okay. Cholesterol is like fat in your blood. If your cholesterol is high, there are usually no signs. An unhealthy diet, not doing enough exercise, and a family history can cause this condition. To stay healthy with it being normal eat well and exercise regularly also if necessary take some drugs from the doctor. 

Answered on 6th June '24

Dr. Babita Goel

Dr. Babita Goel

Dear Madam/Sir My Mother aged 59 years old is having Hernia of 2mm.. Doctor recommended for surgery but WBC Count is 16000+. How to control WBC & to Control WBC Which test is recommended?

Female | 59

Your mom's high white blood cell count shows the­re could be an infection. Afte­r her hernia surgery, you'll want to tackle­ that. Doctors usually suggest a blood culture test to pinpoint the­ infection source. High WBC can bring feve­r, fatigue, and discomfort. Treating the infe­ction should lower her WBC count. Make ce­rtain she finishes all her antibiotics as pre­scribed to help get that WBC in che­ck before her proce­dure.

Answered on 11th Sept '24

Dr. Babita Goel

Dr. Babita Goel

My uric acid test report 5.9 please tell me ok not ok

Male | 29

The uric acid level of 5.9 is already above normal. It might remain asymptomatic at first, yet if untreated, it may lead to gout, which is characterized by pain and swelling in the joints. Your uric acid level can be decreased by drinking more water, avoiding alcohol, and less red meat and seafood. Besides this method, exercising regularly may also be beneficial.

Answered on 20th Aug '24

Dr. Babita Goel

Dr. Babita Goel

My patlet -154000 MPV -14.2 Is it ok

Male | 39

A platele­t count below 150,000 is considered low. Plate­lets help the blood clot prope­rly. Low levels can cause bruising e­asily, bleeding, or tiny red spots calle­d petechiae. An MPV of 14.2 is slightly be­low normal too. This could happen due to infections, me­dications, or medical issues. It's crucial to talk to your doctor about these­ results. They'll check furthe­r and recommend the right tre­atment.

Answered on 5th Sept '24

Dr. Babita Goel

Dr. Babita Goel

Vit b12 very low less than 100 Hscrp very high 20.99( taken at the time of menstruation) Hb slightly low 11.6 Bun creatinine slightly low Iron was very low 34.46 AVG bld glucose slightly low 88

Female | 19

It looks like there are certain elements that are below the required levels in your body. For it to function properly, your body needs them. Feeling tired, weak, or unlike yourself can be signs of insufficient amounts of these substances. When some substances are too many, then it may mean that the body is fighting something. To help you feel better soon, you might have to take such supplements like Vitamin B12 or Iron among others. 

Answered on 27th May '24

Dr. Babita Goel

Dr. Babita Goel

I am 16 years old I am suffering from sickle cell I currently have pain all over my body please help me

Female | 16

Sickle cell is a condition where your red blood cells are of the wrong shape that can easily block the blood flow of the blood and thus become painful. This phenomenon occurs in every part of the body. It can lead to fatigue as well. To heal, you are recommended to take warm baths, drink water, and rest. You should also talk to your doctor for more help. 

Answered on 9th Sept '24

Dr. Babita Goel

Dr. Babita Goel

I am loosing weight continuously and getting slim like anaemia patients skin is so dull and sagging and I feel dizzy sometimes, get tired easily can't sit longer because my blood cells stops working so I have to move every moment

Female | 23

Anemia results from a deficient number of healthy red blood cells in the bloodstream. Low red blood cells mean asthma, dizziness, and quick weight loss. Your skin can also become pale and saggy. More spreadsheets with foods high in iron such as spinach and beans are advisable. Your doctor can also give you iron pills to increase the number of red blood cells. 

Answered on 4th Sept '24

Dr. Babita Goel

Dr. Babita Goel

Typhoid IgM antibody Weak positive means..??

Female | 21

Typhoid IgM antibody denote­s your system battles a nasty bug, typhoid feve­r. High temprature, fatigue, tummy hurt, head pain. Te­st helps spot early. Hydrate we­ll. Take antibiotics. Rest up. Follow doctor's orders. 

Answered on 25th July '24

Dr. Babita Goel

Dr. Babita Goel

I have test today wbc is 12800 And neut 42, lymph 45

Male | Jay

A white blood cell count at 12,800 with neutrophils at 42% and lymphocytes at 45% indicates the possibility of an infection. The symptoms may be such as the fever, the fatigue, and body aches. The reasons can be a bacterial or viral infection. Stay home, drink fluids, and eat well. If the symptoms are getting worse or not disappearing, you have to see a doctor immediately.

Answered on 21st Oct '24

Dr. Babita Goel

Dr. Babita Goel

My wife is suffering with low hemoglobin, RBC , WBC & patlets count gone on decreasing .She has sufferd with viral fever for 15 days, viral fever came to normal but counts were not increasing.she has treated 20 days in KIMS, hyderabad hospital. Kims doctors told that after few days gradually counts will increase. What is her problem upto now doctors did not diagnosis, Two or three days doctors are transmitting sdp and prbc and WBC injections.I'm taken second opinion he told that there is a problem in bone marrow.without daignoses if we take bone marrow treatment does patient get any side effects.she is suffering from legs pain and swalling in legs aslo and she is becoming weak. Please what is her problem give me the clarity

Female | 36

she needs detailed hematological evaluation.and depending on all the reports, diagnosis can be made 

Answered on 23rd May '24

Dr. Soumya Poduval

We have done test of asylum serum and it is increased in reports at 142. Is it something to worry about

Male | 44

You had a high result for asylum se­rum, at 142. This could signal an issue with your liver or bones. Fe­eling tired, losing weight, or be­lly pain, are possible symptoms. Causes: live­r problems, or bone troubles. It's wise­ to see a doctor to find out what's happening. The­y can determine the­ right treatment. 

Answered on 23rd July '24

Dr. Babita Goel

Dr. Babita Goel

I have 16 pea sized lymph nodes I am 57kg my height is 5ft 10 I’ve had them for almost 2 years and they haven’t got bigger or changed I’ve had blood tests previously and they all came back fine. I do have 2 under my jaw that’s a bit bigger than a pea though. Is it a concern? I have no symptoms except bad anxiety. I am highly afraid of cancers

Male | 17

Your lymph nodes not changing size or growing for two years is good. When it comes to cancer we tend to worry a lot due to anxiety. They might remain slightly enlarged sometimes. It’s usually benign but it would be prudent to get the larger ones checked by your doctor. Additionally, work on calming down your nerves because that can also be of help.

Answered on 26th Oct '24

Dr. Babita Goel

Dr. Babita Goel

Platelet count noly. 5000

Male | 9

A platelet count of 5000 is very low. Platelets are small UCS in your blood that support the process of transporting blood to your body. When your count is low you could experience symptoms such as easy bleeding, a lot of bruises, or have nosebleeds. Low platelets can be a side effect of several medicines, infections, or diseases. To tackle the problem, doctors may either prescribe medication or transfuse safe platelets. 

Answered on 11th Sept '24

Dr. Babita Goel

Dr. Babita Goel

So my friend has her blood test done recently as she was having low fever, cough, shivers and vomitings. The report showed that she has 57.03 U/dl of CRP after the medication as well it continued to increase to 74.03 CRP although the symptoms such as fever, cough, shivers and vomitings have reduced just wanted to know if such levels of CRP are severe and life threatening or not cause we are worried

Female | 19

A high level of C-reactive protein (CRP) in the blood, even after medication, can be a sign of persistent inflammation or infection in the body. If not treated, this could become a danger. The good news, the symptoms have improved, but the increasing levels of CRP are a reason for concern, as they indicate that the problem needs to be investigated further by a doctor to determine the underlying cause and ensure appropriate treatment. 

Answered on 18th Oct '24

Dr. Babita Goel

Dr. Babita Goel

Hi.. I'm always struggling with being very skinny and I can't gain weight and my iron level always drops, I did blood analysis and everything was good except iron level. I reached many doctors and they gave up because the diagnosis still dim ????. Thanks in advance doctor .

Female | 24

The typical symptoms of iron defusion consist of fatigue, weakness, and trouble gaining weight. The most prevalent cause of low iron is that you don't get enough of it in your diet. Iron-rich foods such as red meat, beans, and green leaves can do a good help. Besides consuming iron supplements, which should be prescribed by a doctor, one will also be able to improve one's iron levels. Don't forget to see your doctor to get more directions. 

Answered on 9th Sept '24

Dr. Babita Goel

Dr. Babita Goel

Yesterday my nose is blood bleeding and today is feeling discomfort.

Female | 24

Your noseble­ed yesterday like­ly irritated. Dry air and nose picking often trigge­r nosebleeds. The­ discomfort today might stem from that irritation. Using a humidifier adds moisture, which can he­lp. Avoid picking your nose too. If issues persist, consult a doctor.

Answered on 5th Sept '24

Dr. Babita Goel

Dr. Babita Goel

I had an I pill last month and my blood tests today are High platelet counts Wbc count -7.95 Gran %-76.5 Platelets -141 PDW-SD-19.7 What does this mean

Female | 19

Your blood test shows some changes. A high platelet level might indicate swelling or infection. With a WBC count of 7.95, your body's defense system is active. The Gran% tells about certain white blood cells, which increase when there's an infection. Your platelet count of 141 is normal, but it’s good to keep an eye on it. It seems your body might be fighting off an illness, so it's wise to discuss these results with your doctor for further advice.

Answered on 26th Sept '24

Dr. Babita Goel

Dr. Babita Goel

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  3. Dear Doctor, Due to my father's high blood viscosity, suspi...