The red blood cell count and the erythrocyte sedimentation rate in the diagnosis of polycythaemia vera.

Autor: Nersesjan V; Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark., Zervides KA; Department of Clinical Sciences, Rheumatology, Lund University, Skåne University Hospital, Lund, Sweden., Sørensen AL; Department of Hematology, Zealand University Hospital, Roskilde, Denmark.; Institute for Inflammation Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark., Kjaer L; Department of Hematology, Zealand University Hospital, Roskilde, Denmark., Skov V; Department of Hematology, Zealand University Hospital, Roskilde, Denmark., Hasselbalch HC; Department of Hematology, Zealand University Hospital, Roskilde, Denmark.
Jazyk: angličtina
Zdroj: European journal of haematology [Eur J Haematol] 2020 Jan; Vol. 104 (1), pp. 46-54. Date of Electronic Publication: 2019 Nov 22.
DOI: 10.1111/ejh.13334
Abstrakt: Background: Iron deficiency in polycythaemia vera (PV) may impact the validity of the haematocrit (HCT), since HCT is red blood cell count (RBC) × mean corpuscular volume (MCV).
Objectives: To investigate (a) the effect of microcytosis on HCT, (b) the erythrocyte sedimentation rate (ESR) as a possible additional diagnostic marker for PV.
Material and Methods: This study included 182 subjects: 39 with PV, 27 with essential thrombocythemia (ET) and 116 suspected of myeloproliferative neoplasm (MPN) with a secondary cause for either thrombocytosis or erythrocytosis.
Results: Patients with PV had significantly lower ratio of MCV and serum ferritin compared to MPN suspects. A good correlation of RBC versus HCT was found for PV and MPN subjects when individuals with microcytosis were excluded (R 2  = .87 in PV and R 2  = .82 in MPN suspects). We found a specificity of 98% and a sensitivity of 37% for ESR <2 mm in the diagnosis of PV.
Conclusion: The RBC may more precisely reflect the total red cell mass and accordingly the hypercoagulable state of the PV patient, which is integrated in the ESR. A combination of RBC and ESR is proposed as a novel tool to substitute the Hb concentration and the HCT in the diagnosis of PV.
(© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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