What is the reason for high hemoglobin and RBC levels in a 17 -year-old?

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Elevated hemoglobin is seen in smokers living at high altitudes, congestive cardiac failure, and chronic obstructive pulmonary disease. Some erythropoietin is secreted in adenomas of the kidney, and very rarely, it could be a part of primary polycythemia. Rule out the causes of secondary polycythemia. If all causes are excluded, get JAK2, Exon12, and CALR mutations tested. Even in primary polycythemia, also called polycythemia vera, these mutations are frequently negative. In cases of secondary polycythemia, the treatment of elevated hemoglobin is to treat the cause. In primary polycythemia, if JAK2 is negative, the treatment is therapeutic, including phlebotomy or venesection.

The goal is to keep hemoglobin and hematocrit within the range for males, with less than 50 hematocrits, and females, with less than 48. And hemoglobin in males is 16 and then in females up to 15 g/dL. It can be combined with Hydroxyurea in which the dose could be calculated according to the weight of the patient. Repeated venesections or phlebotomies can lead to micronutrient deficiency, especially iron. The patient should be given micronutrient replacement therapy. For JAK2 positive Patients, Jakavi tablets (Ruxolitinib) are given in a dose of five to 15 mg per day. Another option is Pegasys (pegylated interferon alfa-2a) in low doses (45 ugs per week) in both JAK2 positive and negative cases. CALR positive cases show superior results on this mode. It could take years to cure the disease. Meanwhile, along with all therapeutic modalities, thrombophilia prophylaxis is given. This is not a life-threatening disease. The patient can die with this but does not die of it. In addition, vitamin D is low. Take locally available preparations for this.