A possible complication of COPD, secondary polycythemia is a rare disorder that causes too many red blood cells in the blood. When too many red blood cells are produced, the blood becomes thick, hindering its passage through the smaller blood vessels.
Causes
The job of a red blood cell is to deliver oxygen to the body tissues. Because smoking interferes with this process, it is a common cause of secondary polycythemia. Others include:
- Carbon monoxide poisoning
- Chronic heart or lung disease (like COPD)
- High altitude
- Cysts of the kidneys
- Brain, liver or uterine tumors
Symptoms
Symptoms of polycythemia include the following:
- Weakness
- Headache
- Fatigue
- Lightheadedness
- Shortness of breath
- Visual disturbances
- Pruritis (itching)
- Pain in the chest or leg muscles
- Ruddy complexion
- Confusion
- Ringing in the ears (tinnitus)
- Burning of the hands or feet
Diagnosis
The doctor first must determine if the polycythemia is "primary" or "secondary." Secondary polycythemia is associated with an underlying disease process (such as COPD), but primary polycythemia is not.
Measuring oxygen levels in the blood with a blood test known as arterial blood gases (ABG's), can help doctors formulate a diagnose of secondary polycythemia. Other blood tests include measurement of erythropoietin and red blood cell mass levels.
Additional diagnostic tests may include:
- Chest x-ray
- Electrocardiogram (EKG)
- Imaging studies to determine enlargement of the spleen or liver
Treatment
Treatment for secondary polycythemia should control or eliminate the underlying condition. Symptom relief may include medications such as antihistamines to relieve itching, or aspirin to soothe pain and burning associated with the disorder.
Because it takes time to treat the underlying condition, doctors sometimes use phlebotomy (bloodletting) in an attempt to reduce the number of red blood cells in the blood. As much as a pint may be withdrawn in one setting, as long as the patient can tolerate it.
Prognosis
If the underlying cause of secondary polycythemia is corrected, symptoms usually go away. For more information about secondary polycythemia, see your health care provider.
Source:
Smeltzer, S., Bare, Brenda. Brunner and Suddarth's Textbook of Medical-Surgical Nursing. Eight Edition. 1996. Lippincott-Raven Publishers.
