Polyglobules
Classification according to ICD-10 | |
---|---|
D75.0 | Familial erythrocytosis |
D75.1 | Secondary polyglobules [polycythemia] |
ICD-10 online (WHO version 2019) |
A polyglobulia ( compound from Greek πολύ “much” and Latin globulus “globule”; because of the hemoglobin ), an erythrocytosis (from Greek ερυθρός , erythrós ; German “red” and Greek κύτταρο , kýttaro ; German “cell "As well as gr. -Όση , -óse ; substantivating ending like dt." -Heit ") or a secondary polycythemia (from gr. Αίμα , häma ; dt." Blood "; to differentiate from primary forms of polycythemia ) one calls one through increased formation of new blood increased erythrocyte count or hemoglobin concentration in the blood . The blood count shows an increased hematocrit value.
causes
- as a physiological adaptation to external lack of oxygen , for example in the mountain air
- as a pathophysiological adaptation to internal oxygen deficiency in lung and heart diseases (e.g. in the context of the Eisenmenger reaction ) or in disturbed or defective hemoglobin
- by exposure to toxins or malignant tumors (as for the cause polycythemia or paraneoplastic increased erythropoietin -Ausschüttung in kidney tumors , even at diencephalon MALFUNCTION) or passager in a osteomyelofibrosis
- Doping (or therapeutic treatment) with EPO or androgens
- as a secondary reaction in the case of a very rare defect in the enzyme bisphosphoglycerate mutase in the erythrocytes (see Rapoport-Luebering cycle )
- as a consequence of the fetofetal transfusion syndrome on the part of the acceptor
Differential diagnosis
An only apparent polyglobule, a pseudopolyglobule (or thickening polyglobule ) occurs, for example, when there is a loss of volume in the bloodstream due to dehydration or burns : Here the relative proportion of solids in the blood is too high (increased hematocrit ), without - as defined in a polyglobule demanded - the formation of new red blood cells would be increased.
A differential diagnosis should also be used to determine whether the cause is polycythemia vera .
Effects
The blood thickening reduces the flow properties of the blood (viscosity increases). It can thrombosis (in the eye about as central retinal vein occlusion develop), the risk of stroke and heart attack increases. If a portion of the increased red blood pigment remains unsaturated with oxygen, cyanosis develops , although the oxygen supply to the organism may be sufficient.
treatment
Elimination of the causes, infusions to thin the blood or appropriate medication, infection prophylaxis, bloodletting .
See also
Individual evidence
- ↑ Ludwig Heilmeyer , Herbert Begemann: Blood and blood diseases. In: Ludwig Heilmeyer (ed.): Textbook of internal medicine. Springer-Verlag, Berlin / Göttingen / Heidelberg 1955; 2nd edition ibid. 1961, pp. 376-449, here: pp. 417-419 ( Die Polyglobulie und die Polycythaemia vera ).