Polycythemia, secondary
Also known as reactive polycythemia, secondary polycythemia is a disorder characterized by excessive production of circulating red blood cells (RBCs) due to hypoxia, tumor, or disease. It occurs in approximately 2 of every 100,000 people living at or near sea level; incidence rises among persons living at high altitudes.
Causes
Secondary polycythemia may result from increased production of erythropoietin. This hormone, which may be
produced and secreted in the kidneys, stimulates bone marrow production of RBCs. Increased production may be a compensatory physiologic response to hypoxemia, which may result from:
produced and secreted in the kidneys, stimulates bone marrow production of RBCs. Increased production may be a compensatory physiologic response to hypoxemia, which may result from:
chronic obstructive pulmonary disease
hemoglobin (Hb) abnormalities (such as carboxyhemoglobinemia, which is seen in heavy smokers)
heart failure (causing a decreased ventilation-perfusion ratio)
right-to-left shunting of blood in the heart (as in transposition of the great vessels)
central or peripheral alveolar hypo-ventilation (as in barbiturate intoxication or pickwickian syndrome)
low oxygen content at high altitudes.
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