Thank you so much for the feedback. Truly appreciate it.

Thank you for the question. In general, I look at frequently asked questions, health trends and also like to highlight topics that are informative to medical students. It is always a pleasure to help any individual better understand health issues that are of interest or relevance to them. Hope this was useful. Thank you.

Thank you that’s awesome

Thank you. Your question is an excellent and a thoughtful one as it highlights the importance of understanding the relationship between hematocrit and hemoglobin levels in Polycythemia Vera and factors that may influence this relationship. Generally, factors such as hydration status of the body, bleeding (GI tract, heavy menses etc), pregnancy, living at a high altitude, blood transfusions, renal failure may alter the hematocrit levels. For example a patient with PV and a concomitant anemia may have a fluctuating or normal hematocrit. PV has even been diagnosed in patients who had normal HB and hematocrit levels as a result of one of the factors mentioned above, although a rare situation. In such cases platelet and WBC may still be elevated. So plasma volume expansion may mask the red cell mass making the hematocrit vary or fluctuate. Another example is that PV patients are also prone to peptic ulcer disease and GI-tract bleeding may be a clinical manifestation that can affect hematocrit. Despite all these it is crucial to note that people with PV have about 30% chance of forming blood clots even prior to the diagnosis, hence it must be taken serious to address this in order to avoid a cardiovascular event or an embolism. In summary, PV may progress with a consistent rise in HB and Hct but in rare cases these parameters may also fluctuate. JAK mutation analysis and erythropoietin levels are important in the confirmation of PV. Thank you for your beautiful question.