Investigating the prevalence of polycythemia vera and other etiologies in patients admitted to the adult hematology clinic due to elevated hemoglobin levels

Objective: In this study, the frequency of polycythemia vera and the underlying etiological causes among adult patients presenting to the hematology clinic with elevated hemoglobin levels have been investigated. Analysis of the WBC and platelet levels in the complete blood count before undergoing advanced tests such as JAK2, EPO, and bone marrow biopsy, examination of whether the patients smoke, investigation of the presence of other secondary erythrocytosis-inducing diseases, and analysis of the differences between the two groups classified as PV and Others based on these advanced tests performed on the patients, are all aimed at. Methods and Materials: The study was conducted on patients who visited the adult hematology clinic of İnönü University Medical School between January 2010 and August 2021 with a diagnosis of erythrocytosis. 1484 patients with erythrocytosis were identified and their records were screened through the hospital's electronic record system. Patient demographics, laboratory values, ultrasound findings, and other relevant information were analyzed, including age and gender at the time of diagnosis, levels of hemoglobin and hematocrit, white blood cell count, platelet count, presence of JAK2 mutation, results of bone marrow exams, oxygen saturation as measured by blood gas or pulse oximetry, EPO levels, size of the spleen as seen on ultrasound, smoking habits, presence of comorbidities, and whether a diagnosis of PV was given. The obtained data was recorded. Conclusion: In a study conducted at an adult hematology clinic, the frequency of polycythemia vera (PV) in patients who presented with erythrocytosis was found to be 5.5%. The demographic analysis showed that erythrocytosis was more commonly seen in men, and the proportion of men was also higher among those who were diagnosed with PV. When the patients were classified into two groups, PV patients and others, the majority of PV patients were over 40 years of age, whereas the majority of the others were under 40, with a statistically significant difference found. The study found that all parameters, including hemoglobin, hematocrit, WBC, and platelets, had higher average values among PV patients compared to the other group, with statistically significant differences found. The median value of EPO among the study participants was found to be 1.77 (U/L) in PV patients and 9.87 (U/L) in others, with a statistically significant difference. The JAK2 positivity rate among PV patients was 97.5%, which showed a statistically significant difference compared to others. Of the PV patients who underwent bone marrow biopsy, 76.3% were found to be in agreement with the myeloproliferative neoplasm (MPH) diagnosis. The rate of smoking was found to be statistically higher among those who were not diagnosed with PV. Only 2.4 out of every 100 erythrocytosis patients who smoked were diagnosed with PV. The rate of splenomegaly, confirmed by abdominal ultrasound, was 48.5% (33 patients) among PV patients, and 13.8% among others, with a statistically significant difference found in terms of spleen size between the two groups. No statistically significant differences were found in the comparison of blood gas and pulse oximetry oxygen saturation values between the two groups. The evaluation of comorbidities among the study participants showed that 63 (7.7%) had a diagnosis of COPD, 31 (3.8%) had asthma, 109 (12.1%) had diabetes, 89 (10.9%) had hypertension, and 24 (2.9%) had both diabetes and hypertension Keywords: Erythrocytosis, Polycythemia vera, Polycythemia, Secondary erythrocytosis