INCREASED RED BLOOD CELL COUNT

Polycythaemia

Q: What is the difference between primary and secondary polycythaemia?

Primary polycythaemia (polycythaemia vera) is a bone marrow disorder in which the marrow produces too many red blood cells, often due to a JAK2 mutation. Secondary polycythaemia is caused by conditions that increase erythropoietin production, such as chronic lung disease, smoking or high altitude.

Q: Why is polycythaemia dangerous?

High red blood cell count makes the blood thicker, increasing the risk of blood clots that can cause deep vein thrombosis, pulmonary embolism, stroke or heart attack. This is the main reason for treating polycythaemia and is the most important target of therapy.

Q: Will I need lifelong treatment?

Patients with polycythaemia vera typically need lifelong treatment with phlebotomy, antiplatelet therapy and sometimes specific medical therapy. Patients with secondary polycythaemia may improve significantly when the underlying cause is treated.

A condition with an abnormally high red blood cell count, which can be primary (polycythaemia vera) or secondary to low oxygen states. Managed with cause-specific therapy under haematology care.

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Polycythaemia (high RBC) evaluation and care in Hyderabad

High RBCs UNDERLYING ISSUE

Primary or Secondary TWO MAIN TYPES

Specialist Care ESSENTIAL

ABOUT THIS CONDITION

What is Polycythaemia

Polycythaemia refers to an abnormally high red blood cell count, leading to thicker blood and increased risk of clotting and stroke. It can be primary (polycythaemia vera, a bone marrow disorder where the marrow produces too many red blood cells) or secondary to other conditions that increase erythropoietin production, such as chronic lung disease, smoking, high altitude, sleep apnea, certain heart conditions and rare kidney tumours. Typical features include tiredness, headache, dizziness, blurred vision, itching (particularly after a hot bath in polycythaemia vera), facial flushing, redness of the skin, enlarged spleen and increased risk of blood clots — leading to deep vein thrombosis, stroke, heart attack and other complications. Diagnosis involves complete blood count, erythropoietin levels, bone marrow examination and genetic testing for the JAK2 mutation. Treatment depends on the type and includes therapeutic phlebotomy (regular blood removal), specific medical therapy in selected cases, and management of underlying causes in secondary polycythaemia. Dr. Patnam Pravallika Reddy provides initial evaluation and co-management with haematology at Lux Hospitals, Hyderabad.

SIGNS TO WATCH

Common Symptoms

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Symptoms that need attention

Tiredness and weakness Headache and dizziness Blurred vision Itching, particularly after a hot bath Facial flushing and redness of skin Enlarged spleen Increased risk of blood clots — deep vein thrombosis, stroke

WHY IT HAPPENS

Causes & Risk Factors

Polycythaemia vera (bone marrow disorder) — primary form
Chronic lung disease and low blood oxygen
Smoking
Sleep apnea
High altitude
Certain heart conditions
Rare kidney or other tumours producing erythropoietin

CLINICAL DETAILS

KeyFacts

Diagnosis

Complete blood count, erythropoietin levels, JAK2 genetic testing, bone marrow examination

Types

Primary (polycythaemia vera) · Secondary (due to other conditions)

Treatment

Therapeutic phlebotomy, specific medical therapy and treating underlying causes

Clotting risk

Major concern requiring antiplatelet therapy in many patients

Specialist care

Haematology co-management is essential

Hospital

Available at Lux Hospitals, Hyderabad — co-managed with haematology

HOW WE TREAT IT

Treatment Approach

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Phlebotomy with Specialist Care

The most effective approach is identifying whether polycythaemia is primary or secondary, followed by targeted treatment — therapeutic phlebotomy, antiplatelet therapy, specific medical therapy for polycythaemia vera, and addressing underlying causes in secondary forms — all under haematology co-management.

1

Consultation & Assessment

Dr. Pravallika reviews symptoms and possible causes, examines the patient and arranges blood tests including erythropoietin levels and JAK2 testing.
2

Treatment Planning

A personalised plan is created in coordination with haematology, with specific treatment for polycythaemia vera or management of secondary causes.
3

Medical Management

Therapeutic phlebotomy, antiplatelet therapy, specific medical therapy in selected cases and treatment of underlying causes.
4

Recovery & Follow-up

Long-term follow-up with regular blood tests, monitoring of haematocrit and management of any complications.

AVAILABLE TREATMENTS

Treatment Options

Therapeutic Phlebotomy

Regular removal of blood reduces red blood cell count and haematocrit, lowering the risk of clotting complications.

Antiplatelet Therapy

Antiplatelet therapy reduces the risk of stroke and other clotting events in patients with polycythaemia vera.

Specific Medical Therapy for Polycythaemia Vera (Referral for haematology)

Specific medical therapy reduces red blood cell production and is used in selected patients with polycythaemia vera under specialist care.

Treatment of Underlying Causes

Addressing causes of secondary polycythaemia — chronic lung disease, sleep apnea, smoking — significantly improves the condition.

Long-Term Monitoring

Regular monitoring of blood counts, symptoms and complications guides ongoing therapy adjustments.

COMMON QUESTIONS

Frequently Asked Questions

What is the difference between primary and secondary polycythaemia?+

Why is polycythaemia dangerous?+

Will I need lifelong treatment?+

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