Applying an algorithmic and reflexive approach to diagnosis
Updated: December 2014
Published: December 2012
Management and Diagnosis of Erythrocytosis
The testing options for general erythrocytosis greatly benefit from an algorithmic and reflexive approach for a cost-effective and efficient evaluation.
- Most cases are due to polycythemia vera, and knowledge of the JAK2 V617F status is an optimal place to begin.
- Additionally, the serum erythropoietin level allows stratification of JAK2 V617F negative cases.
- If the serum erythropoietin level is normal or elevated, testing for oxygen dissociation, p50 helps further define the process and suggests the most likely potential etiologies and the best testing strategy.
- When polycythemia vera and acquired causes of erythrocytosis are excluded and the p50 value is normal, an evaluation for hereditary erythrocytosis should be ordered.