Causes, symptoms and treatment of erythrocytosis
What is erythrocytosis?
Erythrocytosis is a condition of the human body associated with a pathological increase in the number of erythrocytes and the level of hemoglobin in the blood up to 6 T / L and 170 g / L (or more), respectively. Erythrocytosis is precisely an indicator of pathology, but not a disease as such.
Most often, this condition is considered from an adaptive position and is one of the functions of the body in a certain pathophysiological process. In some cases, erythrocytosis is a manifestation of hypoxia in its chronic course or oncology.
Causes of erythrocytosis
The occurrence of erythrocytosis is facilitated by several reasons, which depend on the varieties of this pathology. In a similar state, the relative and true forms are distinguished. Relative erythrocytosis is characterized by a large number of erythrocytes per unit volume of blood, while the blood plasma is significantly reduced. The number of erythrocytes remains unchanged.
Relative erythrocytosis occurs for the following reasons:
- the body loses a large amount of fluid, but cannot fully replenish it;
- stressful situations;
- hypertensive crises;
- different stages of obesity.
True erythrocytosis is understood as an increase in the number of erythrocytes in the blood as a result of their intense appearance in the bone marrow.
The occurrence of absolute erythrocytosis is facilitated by several reasons:
- Genetics. Changes at the enzymatic level in the composition of the erythrocyte, which is responsible for the attachment and release of oxygen. Lack of oxygen in tissues and organs triggers the mechanism of an increase in red blood cells in the bone marrow.
- Hypoxic changes. High hemoglobin levels due to exposure to carbon monoxide (especially common in smokers), respiratory diseases, Pickwick syndrome and heart defects lead to a similar condition.
- High rates of erythropoietin production - a stimulator of erythrocyte formation resulting from kidney disease (renal cyst, hydronephrosis, hypernephroma) and malignant neoplasms (pheochromocytoma, hepatoma, pituitary adenoma, cerebellar hemangioblastoma).
Symptoms of erythrocytosis
The symptoms of erythrocytosis depend on the stage of the pathological condition.
The first (initial) stage corresponds to moderate blood erythrocytosis with the following symptoms:
- the occurrence of panmyelosis in the red bone marrow;
- absence of vascular and visceral complications;
- a slight increase in the spleen, not palpable.
This stage can take a long time, over several years.
Next comes the proliferative (expanded) stage, which is marked by the following symptoms:
- a plytora of a pronounced character;
- the occurrence of hepatosplenomegaly;
- recurrent thrombosis;
- depletion of the body;
- the growth of basophil cells;
- increased concentration of uric acid in the blood serum.
At this stage, erythrocytosis is diagnosed.
The next stage, anemic, is a stage of exhaustion when:
- the liver and spleen increase in size;
- more and more saturation with pancytopenia occurs in the blood;
- in the red bone marrow, foci of myelofibrosis are noted.
All the symptoms of the underlying disease in patients with established erythrocytosis are observed:
- special purple cyanosis;
- dizziness, up to fainting;
- headaches;
- nosebleeds;
- frequent thrombotic complications.
Primary and secondary erythrocytosis
The etiology of erythrocytosis divides them into primary, or hereditary, and secondary, i.e. acquired.
Secondary erythrocytosis is characteristic of various diseases of a somatic nature and has a very diverse clinical picture. The hemogram usually shows overestimated red blood cell counts - moderate or significant. Leukocytes and platelets are within normal limits.
In the event that, as a result of the examination, the patient excludes the presence of secondary erythrocytosis, they speak of the hereditary nature of the pathological condition.
Primary erythrocytosis is most commonly diagnosed in children and adolescents. The disease has some features:
- discoloration of the face, or red cyanosis;
- a blood test detects overestimated red blood cells, hemoglobin and hematocrit;
- the number of leukocytes and platelets is within the normal range;
- the viscosity of the blood is increased due to the overflow of blood vessels;
- blood flow in the vessels slows down.
In the absence of treatment for this type of erythrocytosis, vascular complications are possible, especially for the blood coagulation factor, leading to the formation of thrombosis.
Erythrocytosis treatment
The main task of the treatment of erythrocytosis is to remove excess, excess erythrocytes by reducing the degree of blood viscosity. In therapy, a complex of methods with the use of drugs is used. If erythrocytosis is associated with diseases of the respiratory or cardiovascular system, then, first of all, the underlying disease is treated. The main rule of dealing with erythrocytosis is to eliminate the cause of the pathological condition.
Hypoxic erythrocytosis requires therapeutic measures using oxygen. Vascular shunts are treated with surgery.
For patients who smoke, the first and main recommendation is to quit the addiction. Excess body weight is eliminated through a strict diet.
In exceptional cases, when it is impossible to establish the root cause of erythrocytosis, an assessment of the real threat and the likelihood of undesirable consequences and complications is necessary.
Bloodletting is a common treatment. However, it requires caution in diseases such as chronic obstruction of the lungs, heart defects of various origins. Such diseases associated with erythrocytosis allow bloodletting techniques. The volume of blood during such procedures should not exceed 200 ml weekly with a hematocrit of at least 50%. A hematocrit of 50 to 60% is a relative indication for phlebotomy, and a 60% barrier is a clear indication for this procedure.
With erythrocytosis of any kind, therapy with cytostatic drugs is not carried out. Treatment also excludes the intake of vitamin complexes. The prognosis for the development of a pathological condition and complete recovery depends on the underlying disease.
A clinical blood test allows you to determine many different indicators, including developing erythrocytosis. An experienced doctor will be able to assess the state of the hematopoietic organs and the functioning of the organs and systems of the human body precisely by the result of this analysis. Competent and timely treatment received will avoid serious complications and will improve the normal functioning of the circulatory system.
The author of the article: Shutov Maxim Evgenievich | Hematologist
Education: In 2013 he graduated from the Kursk State Medical University and received a diploma "General Medicine". After 2 years, completed residency in the specialty "Oncology". In 2016 completed postgraduate studies at the National Medical and Surgical Center named after N. I. Pirogov.
