32 Fig 32.1 Red cell mass and plasma volume in normality, true polycythaemia and apparent polycythaemia. Clinical features. The raised red cell mass and total blood volume with associated hyperviscosity causes the symptoms and signs of the disease. Common complaints include headaches, dizziness, lethargy, sweating and pruritus (the latter particularly after a hot bath). Most importantly, there is an increased risk of arterial and venous thrombosis, particularly strokes. Paradoxically, a combination of hyperviscosity and platelet dysfunction may cause a bleeding tendency. The increased cell turnover can lead to gout (Fig 32.3). Patients are characteristically plethoric and may have rosacea (Fig 32.4). Palpable splenomegaly may be present.
Polycythaemia
Introduction
(a) Normal red cell mass (RCM) and plasma volume (PV). (b) True polycythaemia: there is a significant increase in RCM and total blood volume. (c) Apparent polycythaemia: RCM and PV are at the upper and lower limits of the normal range with a resultant increased haematocrit.
Clinical syndromes
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Polycythaemia
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