Who needs a therapeutic phlebotomy?

Therapeutic phlebotomy may be indicated for hemochromatosis, polycythemia vera

polycythemia vera

Polycythemia vera is an uncommon myeloproliferative neoplasm in which the bone marrow makes too many red blood cells. It may also result in the overproduction of white blood cells and platelets. Polycythemia vera. Other names.

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Polycythemia vera - Wikipedia

, porphyria cutanea tarda, and polycythemia secondary to arterio-venous fistulae, cyanotic congenital heart disease or cor pulmonale.

What conditions require therapeutic phlebotomy?

There are currently three major indications for therapeutic phlebotomy: hemochromatosis, polycythemia vera, and porphyria cutanea tarda. Other indications include sickle cell disease and nonalcoholic fatty liver disease (NAFLD) with hyperferritinemia.

What hemoglobin level requires phlebotomy?

Iron Disorders Institute Advisory Board recommends against phlebotomy (with few exceptions) for patients whose hemoglobin is lower than 12.5g/dL.

When Should therapeutic phlebotomy be indicated?

Therapeutic phlebotomy is indicated for symptomatic patients to prevent complications or those who have already developed end-organ damage, with a serum ferritin greater than 300 μg/L for men or post-menopausal women and greater than 200 μg/L for pregnant females⁵⁰.

Why is therapeutic phlebotomy done?

At the most basic level, therapeutic phlebotomy is the drawing of blood with an express clinical purpose. Instead of removing blood simply for testing, the goal of therapeutic phlebotomy is to remove blood in an effort to decrease the levels of certain substances in the patient's body.

Therapeutic Phlebotomy

Why do I need a phlebotomy test?

Why do I need a blood test? There are a number of reasons why your doctor may request that you have a blood sample taken. These are usually to: • Aid diagnosis, To monitor treatment, • To exclude certain conditions, • As preventative medicine.

What are two conditions that cause polycythemia?

The most common causes of secondary polycythemia include obstructive sleep apnea, obesity hypoventilation syndrome, and chronic obstructive pulmonary disease (COPD). Other causes include testosterone replacement therapy and heavy cigarette smoking.

What are the symptoms of polycythemia?

How much blood is therapeutic phlebotomy?

Blood may be collected in a bag or in syringes. Typically, in adults, a pint of blood (450 - 500 mL) is removed at a time. 1 The frequency of phlebotomy will vary based on your medical condition and laboratory values.

What level of hematocrit requires phlebotomy?

All patients with PV should undergo phlebotomy to keep their hematocrit below 45%. Lower hematocrit targets have been proposed for women with PV, but no empiric evidence supports that recommendation. All patients with PV should take aspirin, 81 mg daily, unless contraindicated by major bleeding or gastric intolerance.

What is a critically low hemoglobin level?

What hemoglobin levels are considered severe or dangerously low? A hemoglobin level of less than 5.0 grams per deciliter (g/dl) is dangerous and could lead to heart failure or death. A normal hemoglobin level is 13.2–16.6 grams per deciliter (g/dL) for males and 11.6–15 g/dL for females.

What level of hemoglobin is dangerously high?

The threshold for a high hemoglobin count differs slightly from one medical practice to another. It's generally defined as more than 16.6 grams (g) of hemoglobin per deciliter (dL) of blood for men and 15 g/dL for women.

What is considered a dangerously low ferritin level?

Ferritin: usually low in iron deficiency. Less than 10 is virtually diagnostic of iron deficiency anemia, while levels between 10 and 20 are suggestive.

What would cause HGB to be high?

A high hemoglobin count occurs most commonly when your body requires an increased oxygen-carrying capacity, usually because: You smoke. You live at a high altitude and your red blood cell production naturally increases to compensate for the lower oxygen supply there.

Does phlebotomy increase platelets?

Phlebotomy may be the only treatment necessary for some people, for many years. However, this procedure does not treat elevated platelet levels (thrombocythemia), elevated white blood cell levels (leukocytosis), itchy skin or gout. In some cases, phlebotomy may contribute to elevated platelet levels.

Will I feel better after phlebotomy?

After it's done, your blood will be thinner and flow better. You'll usually feel better, too. Some symptoms will get better, such as headaches or dizziness. Your doctor will decide how often you need phlebotomy.

What can I expect after therapeutic phlebotomy?

What will happen after therapeutic phlebotomy? You may have lightheadedness, dizziness, sweating, paleness, or fatigue after a phlebotomy. This can lead to fainting. You will need to stay seated for several minutes and then stand up slowly.

What are the side effects of phlebotomy?

Why is hemochromatosis called the Celtic curse?

The Celtic curse refers to the disease of hereditary hemochromatosis, or HH. It is so-called because it is common in people of Celtic background: Irish, Scots, Welsh and British.

What is the difference between polycythemia vera and polycythemia?

Polycythemia, also called erythrocytosis, refers to an increase in red blood cell mass, noted on laboratory evaluation as increased hemoglobin and hematocrit levels. Polycythemia vera is a subtype of polycythemia and is associated with the overproduction of all 3 cell lines.

What are the first symptoms of polycythemia vera?

Which is a major complication of polycythemia?

Blood clots are the most serious complication of PV. Blood clots can cause a heart attack or stroke.

What is the life expectancy of someone with polycythemia vera?

Recent studies estimate the average life expectancy after diagnosis with polycythemia vera to be about 20 years. The average age of death is about 77. The most common cause of death is complications from blood clots (about 33%). Advancing cancer is the second most common cause (15%).

What cancers cause high red blood cell count?

Can polycythemia be caused by stress?

It is concluded that mild relative polycythaemia could be induced by acute emotional stress. In subjects with the Type A behaviour pattern a slight haemoconcentration is present already at rest, which further increases during stress.