Erythrocytosis - is a certain pathological condition of the body, which is characterized by an increase in the blood stream of red blood cells and hemoglobin.The presence of erythrocytosis a person can speak with increasing erythrocytes of 6 T / L and hemoglobin - from 170 g / l.
important to understand that polycythemia - a measure of the pathological process.In a way polycythemia is a kind of "mirror disease" because often it appears as a function of the body's adaptation to specific pathophysiological processes.In addition, polycythemia can be a manifestation of neoplastic processes or chronic hypoxia and may be the only manifestation of them.Therefore, it is necessary to know all the manifestations of this condition and the reasons for which it may cause.It is necessary for its timely detection and treatment you need to get done before the body is not irreversibly damaged.
causes of erythrocytosis different.
There are physiological erythrocyt
important to note that this process is not instantaneous, and develops gradually as a function of adaptation to hypoxia.It is therefore necessary to look for polycythemia in those who spent quite a lot of time in the rarefied air.
physiologically polycythemia occurs in newborns.Since the baby received in utero maternal blood, in which the percentage of oxygen was much less than the percentage in the air.Therefore, the birth of the child the higher the number of red blood cells than with a similar analysis, for example, 2-3 days after birth.
Besides physiological emit two types: absolute and relative polycythemia.
Absolute erythrocytosis occurs due to increased erythropoietic bone marrow function.It can stimulate chronic lung disease (such as COPD, emphysema, blue congenital heart defects: tetralogy of Fallot).
Relative polycythemia - is to increase the number of red blood cells and hemoglobin per unit volume of blood, due to lack of plasma volume.A striking example of the relative erythrocytosis - this blood loss, decreased volume of circulating fluid vomiting, massive diarrhea.
There are primary and secondary erythrocytosis
erythrocytosis primary reasons are to a genetic defect due to which the red blood cells more difficult give oxygen tissues.There are genetic defects in the globin part of the hemoglobin molecule is broken or the content of the erythrocytes special controller, which is responsible for its oxygenation and deoxygenation ("loading" and "unloading" of oxygen in red blood cells).As a result, this increases the affinity of hemoglobin for oxygen and worsens its efficiency tissues.Hemic developing hypoxia of the body that stimulates the secretion of erythropoietin by the kidneys that stimulates erythropoiesis in the bone marrow.
The secondary (symptomatic polycythemia) include such erythrocytoses that have arisen as a consequence of other diseases.
secondary polycythemia also divided into relative and absolute.The secondary absolute polycythemia include state, due to which, as a result of more active erythropoiesis or exit into the bloodstream from the bone marrow, increases the number of red blood cells per unit volume of blood.
absolute erythrocytosis secondary reason may serve different states.For example, diseases associated with ischemia or neoplastic lesions of the kidney, so that there is a large release of erythropoietin, which will be an incentive for the creation of new red blood cells in the bone marrow.
Situations accompanied by renal ischemia can cause renal cysts, and various inflammation, renal artery stenosis, hydronephrosis.For neoplastic lesions of the kidney, which will lead to increased production of red blood cells can be attributed hypernephroma kidney nephroblastoma tumors secreting erythropoietin.In addition, an increased number of red blood cells can cause kidney transplantation, blood transfusion athletes.
also polycythemia can cause a variety of disorders of neurohumoral regulation, under which will be excited by the sympathetic nervous system.
In addition to the increased production of erythropoietin may result and increased production of hormones.This is due to the fact that thyroid hormones, adrenocorticotropic hormones, catecholamines and glucocorticoids increase the utilization of oxygen by the body.A further scheme reaction of the body to reduce its oxygen is quite predictable: in response to hypoxia in the blood will erythropoietin, followed by the increase in the number of red blood cells.It also may include receiving androgenic steroids as doping, to increase muscle mass.
important example of absolute erythrocytosis secondary are those that have emerged as a result of tumor diseases of red germ hematopoiesis in bone marrow.A striking example of these diseases - this is the true erythremia Vakeza or illness.It is characterized by a significant erythropoiesis: The number of red blood cells in the blood of such patients may increase 7-10 times the norm.
One of the highlights of the reasons, of course, is the effect of hypoxia and lung diseases at the onset of symptomatic polycythemia.There are hematic, respiratory, circulatory and tissue hypoxia.
When hemic hypoxic erythrocytosis develops as a result of reducing the oxygen capacity of the blood from.As an example, here is suitable carbon monoxide poisoning, nitro compounds.
circulatory hypoxia induces erythropoiesis due to insufficient pumping function of the heart and insufficient blood supply to tissues and organs.A prime example of this type of hypoxia is heart failure.
Respiratory hypoxia - is a consequence of different diseases of the pulmonary system, which resulted in reduced volume of alveolar ventilation.Examples are: bronchial asthma, chronic bronchitis, chronic pulmonary disease different.
Tissue hypoxia occurs as a result of reduction of biological oxidation.It can arise from any of the above described progression of hypoxia.
polycythemia secondary genesis may occur and exogenous hypoxia hypobaric and normobaric type.When normobaric hypoxia body does not receive oxygen from the air, at normal barometric pressure in the environment.Examples are the cases when a person is a long time in a small space with poor air currents (wardrobe, elevator, mine).When hypobaric type of increase in the number of red blood cells is obtained due to the reduction of the barometric pressure.A striking example is the decompression sickness.
For relative polycythemia secondary genesis include gemokontsentratsionnye form and redistribution.Gemokontsentratsionny erythrocytosis occurs due to loss of water from the vascular bed.Example: The release of strong human sweat in the working conditions at high temperatures, prolonged thirst, vomiting and diarrhea with infectious diseases, the effects of burns, ketoatsidoticheskaya coma in patients with diabetes, ulcerative skin lesions.
redistributive forms are formed when in different stressful situations in the circulating blood rapidly ejected red blood cells that were found earlier in the depot organs and tissues.
One of the most interesting reasons is symptomatic erythrocytosis syndrome Gaysbeka (illness Gaysbeka).It is characterized by a combination of erythrocytosis with hypertension.Its causes are unknown.There are theories about the genetic predisposition to the disease.
erythrocytosis Symptoms generally depend on the type and are quite different.For example, the color of the skin of patients with an absolute increase in red blood cells will pletoricheskoy - red.When the relative shapes, color is usually not changed.Also, in both forms of an objective study, no enlargement of the spleen.
When cyanotic options erythrocytosis in patients in the clinical picture is dominated by cyanosis of the skin, which is strong in the supine position.All erythrocytoses associated with renal disease, are likely to be combined with high hypertension.
When hereditary causes of increasing the number of red blood cells will be observed eritrotsianoticheskaya skin color - red with the presence of cyanosis (as the body moves hypoxia and contains a large number of red blood cells in the bloodstream).Also, this option will be shown in patients with childhood.
Vakeza's disease patient will present characteristic symptoms: krasnuaya bright coloring of the face and skin;itchy skin after bath procedures and pathological enlargement of the spleen.
is important to know that the number of acquired forms of erythrocytes increased, as a consequence of compensatory reactions of the organism.Therefore, most of the normalization factor that caused the disease, secondary erythrocytosis disappear.
also possible headaches, neurological symptoms in the brain causes.It may appear fatigue, drowsiness, weakness in response to the increase in the viscosity of blood and tissue hypoxia.There is a risk of thrombosis.
To determine this or that form of the disease need to spend some laboratory tests:
- Study of blood count: the level of red blood cells in men and women
- Definitions of erythropoietin in serum
- Investigation of blood gas
- Measuring levels of hematocrit and hemoglobin
- Ultrasound examination of the heart and blood vessels
- Determination of reticulocytes (young precursors of red blood cells) in the blood
- Determination of the number of platelets and white blood cells (to differentiate the diseaseVakeza)
Treatment erythrocytosis is based on treating the etiological factor that caused it.Patients with hypoxic forms of the therapy with oxygen.When eritremii prescribed bloodletting under appropriate laboratory values (hematocrit should be at least 50%).After the procedure, patients are administered for the prevention of a variety of blood-substituting solutions.
A similar treatment as prescribed and patients with relative erythrocytosis, where all the attention is drawn to the recovery of lost plasma volume.In addition, a correction of the condition that caused this type of erythrocytosis.For example, if an infectious disease should appoint a therapy directed against the pathogen.If you have symptoms of coma ketoatsidoticheskaya change the dose of insulin administered isotonic infusions.If the cause of erythrocytosis steel high temperature, it is necessary to conduct a "lytic" therapy to reduce it.
Surgical treatment for polycythemia may be imposed in the case of the relevant impairment of the underlying disease or its oncological nature.
patients also observe a certain diet: it eliminated fat and iron products.
addition, it is important to use the correct mode of life: smoking patients with erythrocytosis is to quit, and those patients who suffer from overweight, you should gradually reduce your weight.