Can elevated RBC, Hgb, and HCT with JAK2- negative indicate polycythemia vera?

Question

Hello doctor,

My son is 22 years old. His routine physical examination and complete blood count showed elevated RBC, Hgb, and HCT. Hgb was 18, HCT was 59, and normal platelets. Additionally, he had JAK2-negative, exons normal, normal serum EPO, normal B12, normal electrophoresis, and an ultrasound of the abdomen showed a normal spleen. He is a smoker who smokes a pack per day. His hematologist is suspecting polycythemia vera. Is it possible with these findings? I am not convinced.

Answer 1

Hello,

Welcome to icliniq.com.

Thank you for your query.

According to the blood result, we have to rule out polycythemia vera. His EPO (erythropoietin) is normal with no hepatosplenomegaly in USG (ultrasonogram) scan. Moreover, JAK2 and exon marker investigations are negative. So polycythemia vera seems less likely to occur. He could probably have secondary polycythemia due to smoking and hence smoking should be stopped immediately. Regular CBC (complete blood count) screening after smoking stoppage should be done. If Hb (hemoglobin) and Hct (hematocrit) do not improve with time then finally you can plan for a bone marrow biopsy study which can reveal any polycythemia or other myeloproliferative neoplasm if present.

I hope this has helped you.

Thank you.