(HOME) Subject: polycythaemia/sleep apnea/renal cancer/iron

   
   J Clin Pathol 2000 Jul;53(7):561-4
   
Simultaneous occurrence of multiple aetiologies of polycythaemia: renal cell
carcinoma, sleep apnoea syndrome, and relative polycythaemia in a smoker with
masked polycythaemia rubra vera.

    Shih LY, Wang ML, Fu JF
    
   Department of Internal Medicine, Chang Gung Memorial Hospital, Chang
   Gung University, Taipei, Taiwan. sly7012@adm.cgmh.com.tw
   
   A 58 year old male heavy smoker presented with intracranial
   haemorrhage and erythrocytosis. Four aetiologies of
   polycythaemia--polycythaemia rubra vera (PRV), renal cell carcinoma,
   sleep apnoea syndrome, and relative polycythaemia--were found to be
   associated with the underlying causes of erythrocytosis. He did not
   fulfill the diagnostic criteria for PRV at initial presentation, but
   an erythropoietin independent erythroid progenitor assay identified
   the masked PRV, and the low post-phlebotomy erythropoietin
   concentration also suggested the likelihood of PRV evolution. This
   case demonstrates that a search for all the possible causes of
   erythrocytosis is warranted in patients who already have one aetiology
   of polycythaemia.
   
   PMID: 10961184, UI: 20416868
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