Division of Hematology, Department of Medicine, Duke Cancer Institute, Duke University School of Medicine, Durham, NC, USA.
Division of Hematology, Department of Medicine, Duke Cancer Institute, Duke University School of Medicine, Durham, NC, USA.
Eur J Intern Med. 2015 Jun;26(5):297-302. doi: 10.1016/j.ejim.2015.03.007. Epub 2015 Mar 31.
Erythrocytosis is frequently encountered as an incidental abnormality on laboratory testing that reveals persistent elevation of the hematocrit level (>52% in men and >48% in women). In many cases, erythrocytosis is the manifestation of an underlying cardiopulmonary process, drug-induced due to androgens, or secondary to smoking, rather than a primary bone marrow disorder such as polycythemia vera. A systematic approach to the clinical and laboratory evaluation of each patient is indicated to consider diverse differential diagnosis possibilities and to identify the underlying etiology of erythrocytosis in order to formulate appropriate subspecialist referral and management plans. A thorough medical history and meticulous physical examination supplemented by a focused initial laboratory evaluation will enable the general practitioner to ascertain the etiology of erythrocytosis in the majority of cases. Patients with clinical and laboratory features suggestive of polycythemia vera and those patients without an apparent underlying condition known to cause erythrocytosis benefit from early referral to a hematologist for further specialized diagnostic evaluation and therapy considerations.
红细胞增多症常作为实验室检测的偶然异常出现，表现为血细胞比容水平持续升高（男性>52%，女性>48%）。在许多情况下，红细胞增多症是心肺疾病的表现，是由于雄激素引起的药物作用，或是由吸烟引起的继发性疾病，而不是原发性骨髓疾病，如真性红细胞增多症。为了考虑不同的鉴别诊断可能性，并确定红细胞增多症的潜在病因，以制定适当的专科转诊和管理计划，需要对每位患者进行系统的临床和实验室评估。通过详细的病史和体格检查，并结合有针对性的初始实验室评估，大多数情况下，全科医生能够确定红细胞增多症的病因。对于有真性红细胞增多症的临床和实验室特征的患者，以及那些没有明显潜在病因导致红细胞增多症的患者，早期转介给血液科医生进行进一步的专门诊断评估和治疗考虑是有益的。
