The utility of testing erythropoietin level in polycythemia diagnosis
ABSTRACTObjectives: Polycythemia vera (PV) is classically thought to be associated with low erythropoietin (EPO) levels. Here, we present a review of the utility of using EPO levels in diagnosing polycythemia.Methods: We conducted a systematic literature review of the Medline data through Pubmed and...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2023-12-01
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| Series: | Hematology |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/16078454.2023.2269510 |
| _version_ | 1797659280236609536 |
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| author | Abdellatif Ismail Elmustafa Abdalla Ali Aqel Abdalla Fadul Ashraf Ahmed Ahmed Alsayed Muzamil Musa Mohamed A. Yassin |
| author_facet | Abdellatif Ismail Elmustafa Abdalla Ali Aqel Abdalla Fadul Ashraf Ahmed Ahmed Alsayed Muzamil Musa Mohamed A. Yassin |
| author_sort | Abdellatif Ismail |
| collection | DOAJ |
| description | ABSTRACTObjectives: Polycythemia vera (PV) is classically thought to be associated with low erythropoietin (EPO) levels. Here, we present a review of the utility of using EPO levels in diagnosing polycythemia.Methods: We conducted a systematic literature review of the Medline data through Pubmed and Google Scholar. We included the articles which described confirmed PV associated with elevated EPO level. Our search strategy included the following terms in Pubmed (((polycythemia vera[MeSH Terms]) OR (jak2 protein tyrosine kinase[MeSH Terms])) OR (Myeloproliferative Disorders[MeSH Terms])) AND (Erythropoietin[MeSH Terms]), and ‘polycythemia vera with erythropoietin’ in Google Scholar.Results: Our research yielded four cases of PV with elevated EPO levels. The most common symptom was a headache. Thrombotic phenomena happened in a single case in the form of Budd-Chiari syndrome. The mean Hb level was 20.2 gm/dl, and the EPO level was 213 mlU/mL.Discussion: Although PV is usually associated with low EPO levels, high levels do not exclude this diagnosis. Workup should include testing for JAK2 mutation and bone marrow biopsy in the presence of suggestive signs and symptoms. Novel biomarkers are also being proposed to aid in the diagnosis.Conclusion: Although elevated EPO levels suggest secondary causes of polycythemia, cases where elevated EPO levels were associated with an underlying PV are reported in the literature, and we have summarized a review of them. Workup for polycythemia should include JAK2 mutation testing if signs and symptoms suggest PV even if EPO is elevated. |
| first_indexed | 2024-03-11T18:11:38Z |
| format | Article |
| id | doaj.art-e5868dc834e94f56b78fd4b1746caf82 |
| institution | Directory Open Access Journal |
| issn | 1607-8454 |
| language | English |
| last_indexed | 2024-03-11T18:11:38Z |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Hematology |
| spelling | doaj.art-e5868dc834e94f56b78fd4b1746caf822023-10-16T13:51:51ZengTaylor & Francis GroupHematology1607-84542023-12-0128110.1080/16078454.2023.2269510The utility of testing erythropoietin level in polycythemia diagnosisAbdellatif Ismail0Elmustafa Abdalla1Ali Aqel2Abdalla Fadul3Ashraf Ahmed4Ahmed Alsayed5Muzamil Musa6Mohamed A. Yassin7Department of Internal Medicine, University of Maryland Medical Center Midtown Campus, Baltimore, MD, USADepartment of Medicine, Hamad Medical Corporation, Doha, QatarDepartment of Medicine, Hamad Medical Corporation, Doha, QatarDepartment of Medicine, Hamad Medical Corporation, Doha, QatarDepartment of Medicine, Hamad Medical Corporation, Doha, QatarDepartment of Medicine, Hamad Medical Corporation, Doha, QatarDepartment of Medicine, Hamad Medical Corporation, Doha, QatarDepartment of Medical Oncology /Hematology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, QatarABSTRACTObjectives: Polycythemia vera (PV) is classically thought to be associated with low erythropoietin (EPO) levels. Here, we present a review of the utility of using EPO levels in diagnosing polycythemia.Methods: We conducted a systematic literature review of the Medline data through Pubmed and Google Scholar. We included the articles which described confirmed PV associated with elevated EPO level. Our search strategy included the following terms in Pubmed (((polycythemia vera[MeSH Terms]) OR (jak2 protein tyrosine kinase[MeSH Terms])) OR (Myeloproliferative Disorders[MeSH Terms])) AND (Erythropoietin[MeSH Terms]), and ‘polycythemia vera with erythropoietin’ in Google Scholar.Results: Our research yielded four cases of PV with elevated EPO levels. The most common symptom was a headache. Thrombotic phenomena happened in a single case in the form of Budd-Chiari syndrome. The mean Hb level was 20.2 gm/dl, and the EPO level was 213 mlU/mL.Discussion: Although PV is usually associated with low EPO levels, high levels do not exclude this diagnosis. Workup should include testing for JAK2 mutation and bone marrow biopsy in the presence of suggestive signs and symptoms. Novel biomarkers are also being proposed to aid in the diagnosis.Conclusion: Although elevated EPO levels suggest secondary causes of polycythemia, cases where elevated EPO levels were associated with an underlying PV are reported in the literature, and we have summarized a review of them. Workup for polycythemia should include JAK2 mutation testing if signs and symptoms suggest PV even if EPO is elevated.https://www.tandfonline.com/doi/10.1080/16078454.2023.2269510Polycythemia veraPVerythropoietinEPOmyeloproliferative neoplasmsJAK2 mutation |
| spellingShingle | Abdellatif Ismail Elmustafa Abdalla Ali Aqel Abdalla Fadul Ashraf Ahmed Ahmed Alsayed Muzamil Musa Mohamed A. Yassin The utility of testing erythropoietin level in polycythemia diagnosis Hematology Polycythemia vera PV erythropoietin EPO myeloproliferative neoplasms JAK2 mutation |
| title | The utility of testing erythropoietin level in polycythemia diagnosis |
| title_full | The utility of testing erythropoietin level in polycythemia diagnosis |
| title_fullStr | The utility of testing erythropoietin level in polycythemia diagnosis |
| title_full_unstemmed | The utility of testing erythropoietin level in polycythemia diagnosis |
| title_short | The utility of testing erythropoietin level in polycythemia diagnosis |
| title_sort | utility of testing erythropoietin level in polycythemia diagnosis |
| topic | Polycythemia vera PV erythropoietin EPO myeloproliferative neoplasms JAK2 mutation |
| url | https://www.tandfonline.com/doi/10.1080/16078454.2023.2269510 |
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