I have high RBC levels. Is it a symptom of polycythemia?

Question

Hello doctor,

I am 42 years old. My hemoglobin is high for a long time. Currently, my hemoglobin is 18.7, RBC is 6.21. I am feeling itching in the body, and I am taking Cetirizine 10 mg on alternate days.

Ten years back, I have taken Stemiz 10 mg and Astemizole after that, no itching for two years, but this is not available now. I have no other complications.

Please suggest any medicine or treatment.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

Following is my opinion on your question. The positive, alarming finding in your CBC (complete blood count) report includes -

1. High hemoglobin.

2. High PCV (packed cell volume).

3. High RBC (red blood cells).

So, the diagnosis is polycythemia.

Now, polycythemia can be either primary or secondary. Primary polycythemia is a form of myeloproliferative blood cancer, while the secondary form is due to smoking, dehydration, testosterone injection, respiratory disease, or cardiovascular disease.

To rule out primary polycythemia, investigate as follows.

1. Serum EPO (erythropoietin) estimation.

2. JAK2 (Janus-Kinase 2) and Exon 12 mutation by RT PCR (real-time polymerase chain reaction).

To rule out secondary polycythemia, investigate as follows.

1. Chest X-ray.

2. EKG (electrocardiogram).

3. Dehydration, smoking history.

According to the cause, specific treatment is guided.

Meanwhile, you can drink more water, like two to three liters per day. You can lower all your elevated blood counts by therapeutic phlebotomy, in which 350 to 450 ml of blood is removed from the body in one sitting. You can discuss all these with your treating hematologist or physician.

I hope this helps.

Take care.