Polycythaemia

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Polycythaemia, also termed erythrocytosis, is characterized by an absolute increase in the mass of circulating red cells, detectable by a rise in the haematocrit.

Secondary polycythaemia occurs in conditions that give rise to arterial hypoxia, the two main causes being chronic lung disease and cyanotic congenital heart disease.
In these circumstances, hypoxia stimulates expansion of red cell mass.
A similar phenomenon is seen in people who live at high altitudes, such as in the Andes. Uncommonly, abnormal secretion of erythropoietin causes polycythemia, e.g. in renal disease or cerebral haemangioblastoma.

Primary polycythaemia occurs in a condition termed polycythaemia rubra vera, which
is one of the myeloproliferative disorders.
At a haematocrit above 50%, hyperviscosity of blood predisposes to vascular thrombosis,
e.g. causing cerebral infarction.
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