A study on clinical profile and etiological spectrum of polycythaemia in patients presenting to a tertiary care centre in Mallareddy Institute of Medical Sciences, Suraram

Background: Polycythaemia is defined as an increase in the hemoglobin above normal. This increase may be real or only apparent because of a decrease in plasma volume (spurious or relative polycythaemia) and the real polycythaemia can be because of primary due to genetic mutations or secondary due to increased erythropoietin production. The dominant symptoms from an increased red cell mass are related to hyper viscosity and thrombosis (both venous and arterial), because the blood viscosity increases logarithmically at hematocrits >55%. The present study aimed to characterize the different clinical presentations and to find out the complications associated with polycythaemia. Aim and objectives: To identify different clinical presentations of polycythaemia and to evaluate various etiologies of polycythaemia. Materials and methods: Patients with polycythaemia presented to OPD or in patient in the Department of General Medicine in Malllareddy Institute of Medical Sciences, Suraram from June 2020 to January 2022 were included. This was a descriptive observational study in which total of 24 patients were analyzed. Patients with polycythaemia (male Hb >16.5g/dl and females Hb>16.0g/dl) were included. Patients admitted with acute dehydration, sepsis and shock and other conditions leading to spurious polycythaemia and patient on diuretics were excluded. All the patients includedwho were found to have increased RBC mass not including patients from exclusion criteria. A detailed clinical history and physical examination was performed to identify clinical patterns of presentation and look for any complications, and necessary lab investigations were sent accordingly, to evaluate for the cause of polycythaemia. Results: A total of 24 patients were included in the study out of which 16 were males .and 8 were females. Polycythaemia Vera was found in 33% while secondary causes were seen in 67%, patients with polycythaemia vera were found to have more thrombotic complications and the mean age of presentation was in between 30- 40 years. Amongst the secondary causes COPD was the most common cause and smoking was the most common risk factor. Conclusion: Polycythaemia presents wide and varied clinical manifestations. polycythaemia rubra vera is a not an uncommon finding in patients presenting with symptoms of arterial or venous thrombosis, polycythaemia rubra vera is more commonly associated with thrombotic tendencies when compared to secondary causes of polycythaemia, when evaluating a case of polycythaemia it is necessary to look for signs and symptoms of secondary causes, to especially look for erythropoietin secreting tumors an high index clinical suspicion is required in such cases.