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Why is my husband suffering from polycythemia?

Q: My 37 years old husband is suffering from hypertension. He is taking Telmisartan for the last six months and now his blood pressure ranges at 120/80 mm/ Hg. His hemoglobin was 18.2 g/dl for the last 10 years but now came down to 16.9 g/dl. His hematocrit value has also come down and is presently 49. His blood counts are all in the normal range. His TIBC, serum Vitamin B12 is just a bit below normal. His serum iron is normal and EPO is 7.2. His liver function test came normal. He has no enlargement of the liver or spleen, pain, thrombosis or pruritis. A haematologist suggested that he is suffering from polycythemia and has asked him to get a Janus kinase 2 (JAK 2) test done. He also had an attack of pseudo gout three months back. Is it normal to have high haemoglobin level?


Red blood cell production is governed by a hormone called erythropoietin (EPO) that is secreted by the kidney. Erythrocytosis is not a disease but is usually part of some other problem. There are no specific symptoms or physical signs although the underlying disease may cause the patient to seek medical help. Many times, the high hematocrit is noticed when a person has a blood count done as part of an exam for an unrelated complaint.

Haematological values for the normal and abnormal will often overlap, and a value within the recognised normal range (reference interval) may be definitely pathological in a particular subject. As the biological reference intervals for many parameters depend on factors like patient age, sex, sample population and method of testing, it is important that the test result is viewed in the light of the clinical profile, as isolated result can often be un-interpretable.



A mutation in the Janus kinase 2 (JAK2) called JAK2 V617F is found in 74 to 97% patients with polycythemia vera and can help confirm the disease in patients with high red cell counts. Please be guided by your hematologist and get the necessary tests done to help exclude the disease.







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