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Diagnostic approach to the patient with erythrocytosis/polycythemia

Georgina Davidson
(@georgina-davidson)
Active Member

Erythrocytosis (also called polycythemia) refers to an increased hemoglobin concentration and/or hematocrit in peripheral blood. Diagnosing the specific cause of polycythemia is important for proper management of the patient.

This topic discusses the causes of erythrocytosis and our approach to evaluation and diagnosis. The approach to confirming a diagnosis of polycythemia vera is discussed separately. (See “Clinical manifestations and diagnosis of polycythemia vera”.)

The following terms are important for diagnosing and classifying erythrocytosis; note that we use erythrocytosis and polycythemia interchangeably:


Erythrocytosis – Erythrocytosis (polycythemia) is an abnormal elevation of hemoglobin (Hb) and/or hematocrit (Hct) in peripheral blood. We consider the following values to constitute polycythemia [1]:


Increased hemoglobin – >16.5 g/dL (10.3 mmol/L) in men or >16.0 g/dL (10.0 mmol/L) in women

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