Hematology and Hematopathology
- Communiqué: How to Interpret and Pursue an Abnormal Complete Blood Cell Count in Adults
- Hot Topic: Middleware and the Clinical Hematology Laboratory
- Mayo Clinic Video: Polycythemia Vera (PV)
Mayo Clinic Links
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Metabolic Hematology Laboratory (RBC Disorders)
(Test ID: REVP)
Erythrocytosis (increased RBC mass or polycythemia) may be primary—due to an intrinsic defect of bone marrow stem cells (polycythemia vera [PV]), or secondary—in response to increased erythropoietin (EPO) levels. Secondary erythrocytosis is associated with a number of disorders including chronic lung disease, chronic increase in carbon monoxide (due to smoking), cyanotic heart disease, high-altitude living, renal cysts and tumors, hepatoma, and other EPO-secreting tumors.
One of the rare causes of secondary polycythemia is the presence of a high-oxygen-affinity-hemoglobin. Hemoglobins with increased oxygen (O2) affinity commonly result in erythrocytosis caused by an O2 unloading problem at the tissue level.
Testing of Hemoglobin and Blood Cell Abnormalities
The Metabolic Hematology Laboratory (RBC Disorders) performs high-quality esoteric testing of hemoglobin and red
cell disorders, excelling in interpretive diagnoses
reviewed by practicing hematopathologists in the context of comprehensive reflexive panels. Our experts have identified more than 400 hemoglobin variants and described more than 30. Laboratory testing incorporates capillary electrophoresis, mass spectrometry, molecular and flow cytometry expertise, and has expanded the erythrocytosis evaluation panel to include known heritable etiologies.
Optimal Test Utilization
Our test panels link laboratory testing choices to specifically address a clinical question. Because etiologies of red cell disorders vary from common to very rare, reflexive algorithms are used with guidance from experienced staff to add appropriate tests and minimize unnecessary testing. The Metabolic Hematology Laboratory is dedicated to providing accurate diagnoses with integration and discussion of the clinical significance to your patients.
Our consultant and laboratory staff has
extensive depth and breadth of experience in common and uncommon disorders. Dr. Hoyer authored the
College of American Pathologists Color Atlas of Hemoglobin Disorders and contributes to the national database
of hemoglobin variants.