The red blood cell count and the erythrocyte sedimentation rate in the diagnosis of polycythaemia vera

Vardan Nersesjan; Kristoffer A Zervides; Anders L Sørensen; Lasse Kjaer; Vibe Skov; Hans C Hasselbalch

doi:10.1111/ejh.13334

The red blood cell count and the erythrocyte sedimentation rate in the diagnosis of polycythaemia vera

Vardan Nersesjan, Kristoffer A Zervides, Anders L Sørensen, Lasse Kjaer, Vibe Skov, Hans C Hasselbalch

5 Citationer (Scopus)

Abstract

BACKGROUND: Iron deficiency in polycythaemia vera (PV) may impact the validity of the haematocrit (HCT), since HCT is red blood cell count (RBC) × mean corpuscular volume (MCV).

OBJECTIVES: To investigate (a) the effect of microcytosis on HCT, (b) the erythrocyte sedimentation rate (ESR) as a possible additional diagnostic marker for PV.

MATERIAL AND METHODS: This study included 182 subjects: 39 with PV, 27 with essential thrombocythemia (ET) and 116 suspected of myeloproliferative neoplasm (MPN) with a secondary cause for either thrombocytosis or erythrocytosis.

RESULTS: Patients with PV had significantly lower ratio of MCV and serum ferritin compared to MPN suspects. A good correlation of RBC versus HCT was found for PV and MPN subjects when individuals with microcytosis were excluded (R2 = .87 in PV and R2 = .82 in MPN suspects). We found a specificity of 98% and a sensitivity of 37% for ESR <2 mm in the diagnosis of PV.

CONCLUSION: The RBC may more precisely reflect the total red cell mass and accordingly the hypercoagulable state of the PV patient, which is integrated in the ESR. A combination of RBC and ESR is proposed as a novel tool to substitute the Hb concentration and the HCT in the diagnosis of PV.

Originalsprog	Engelsk
Tidsskrift	European Journal of Haematology
Vol/bind	104
Udgave nummer	1
Sider (fra-til)	46-54
Antal sider	9
ISSN	0902-4441
DOI	https://doi.org/10.1111/ejh.13334
Status	Udgivet - jan. 2020

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10.1111/ejh.13334

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title = "The red blood cell count and the erythrocyte sedimentation rate in the diagnosis of polycythaemia vera",

abstract = "BACKGROUND: Iron deficiency in polycythaemia vera (PV) may impact the validity of the haematocrit (HCT), since HCT is red blood cell count (RBC) × mean corpuscular volume (MCV).OBJECTIVES: To investigate (a) the effect of microcytosis on HCT, (b) the erythrocyte sedimentation rate (ESR) as a possible additional diagnostic marker for PV.MATERIAL AND METHODS: This study included 182 subjects: 39 with PV, 27 with essential thrombocythemia (ET) and 116 suspected of myeloproliferative neoplasm (MPN) with a secondary cause for either thrombocytosis or erythrocytosis.RESULTS: Patients with PV had significantly lower ratio of MCV and serum ferritin compared to MPN suspects. A good correlation of RBC versus HCT was found for PV and MPN subjects when individuals with microcytosis were excluded (R2 = .87 in PV and R2 = .82 in MPN suspects). We found a specificity of 98% and a sensitivity of 37% for ESR <2 mm in the diagnosis of PV.CONCLUSION: The RBC may more precisely reflect the total red cell mass and accordingly the hypercoagulable state of the PV patient, which is integrated in the ESR. A combination of RBC and ESR is proposed as a novel tool to substitute the Hb concentration and the HCT in the diagnosis of PV.",

keywords = "Adult, Aged, Blood Sedimentation, Erythrocyte Count, Female, Ferritins/blood, Humans, Male, Middle Aged, Polycythemia Vera/blood, Retrospective Studies, erythrocyte sedimentation rate, haematocrit, red blood cell count, microcytosis, polycythaemia vera, iron deficiency",

author = "Vardan Nersesjan and Zervides, {Kristoffer A} and S{\o}rensen, {Anders L} and Lasse Kjaer and Vibe Skov and Hasselbalch, {Hans C}",

note = "{\textcopyright} 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.",

year = "2020",

month = jan,

doi = "10.1111/ejh.13334",

language = "English",

volume = "104",

pages = "46--54",

journal = "European Journal of Haematology",

issn = "0902-4441",

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TY - JOUR

T1 - The red blood cell count and the erythrocyte sedimentation rate in the diagnosis of polycythaemia vera

AU - Nersesjan, Vardan

AU - Zervides, Kristoffer A

AU - Sørensen, Anders L

AU - Kjaer, Lasse

AU - Skov, Vibe

AU - Hasselbalch, Hans C

PY - 2020/1

Y1 - 2020/1

N2 - BACKGROUND: Iron deficiency in polycythaemia vera (PV) may impact the validity of the haematocrit (HCT), since HCT is red blood cell count (RBC) × mean corpuscular volume (MCV).OBJECTIVES: To investigate (a) the effect of microcytosis on HCT, (b) the erythrocyte sedimentation rate (ESR) as a possible additional diagnostic marker for PV.MATERIAL AND METHODS: This study included 182 subjects: 39 with PV, 27 with essential thrombocythemia (ET) and 116 suspected of myeloproliferative neoplasm (MPN) with a secondary cause for either thrombocytosis or erythrocytosis.RESULTS: Patients with PV had significantly lower ratio of MCV and serum ferritin compared to MPN suspects. A good correlation of RBC versus HCT was found for PV and MPN subjects when individuals with microcytosis were excluded (R2 = .87 in PV and R2 = .82 in MPN suspects). We found a specificity of 98% and a sensitivity of 37% for ESR <2 mm in the diagnosis of PV.CONCLUSION: The RBC may more precisely reflect the total red cell mass and accordingly the hypercoagulable state of the PV patient, which is integrated in the ESR. A combination of RBC and ESR is proposed as a novel tool to substitute the Hb concentration and the HCT in the diagnosis of PV.

AB - BACKGROUND: Iron deficiency in polycythaemia vera (PV) may impact the validity of the haematocrit (HCT), since HCT is red blood cell count (RBC) × mean corpuscular volume (MCV).OBJECTIVES: To investigate (a) the effect of microcytosis on HCT, (b) the erythrocyte sedimentation rate (ESR) as a possible additional diagnostic marker for PV.MATERIAL AND METHODS: This study included 182 subjects: 39 with PV, 27 with essential thrombocythemia (ET) and 116 suspected of myeloproliferative neoplasm (MPN) with a secondary cause for either thrombocytosis or erythrocytosis.RESULTS: Patients with PV had significantly lower ratio of MCV and serum ferritin compared to MPN suspects. A good correlation of RBC versus HCT was found for PV and MPN subjects when individuals with microcytosis were excluded (R2 = .87 in PV and R2 = .82 in MPN suspects). We found a specificity of 98% and a sensitivity of 37% for ESR <2 mm in the diagnosis of PV.CONCLUSION: The RBC may more precisely reflect the total red cell mass and accordingly the hypercoagulable state of the PV patient, which is integrated in the ESR. A combination of RBC and ESR is proposed as a novel tool to substitute the Hb concentration and the HCT in the diagnosis of PV.

KW - Adult

KW - Aged

KW - Blood Sedimentation

KW - Erythrocyte Count

KW - Female

KW - Ferritins/blood

KW - Humans

KW - Male

KW - Middle Aged

KW - Polycythemia Vera/blood

KW - Retrospective Studies

KW - erythrocyte sedimentation rate

KW - haematocrit

KW - red blood cell count

KW - microcytosis

KW - polycythaemia vera

KW - iron deficiency

U2 - 10.1111/ejh.13334

DO - 10.1111/ejh.13334

M3 - Journal article

C2 - 31584701

SN - 0902-4441

VL - 104

SP - 46

EP - 54

JO - European Journal of Haematology

JF - European Journal of Haematology

IS - 1

ER -

The red blood cell count and the erythrocyte sedimentation rate in the diagnosis of polycythaemia vera

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