Complications of Erythrocytosis
The complications of erythrocytosis mainly stem from the blood becoming too thick, which can impair circulation and increase the risk of dangerous clots. While erythrocytosis is manageable, untreated or poorly controlled cases can lead to severe, even fatal, outcomes.
Blood Clots (Thrombosis)
The most serious complication is the formation of blood clots, which can lead to:
Stroke, if a clot blocks blood flow to the brain
Heart attack, if a coronary artery becomes blocked
Pulmonary embolism, a life-threatening clot in the lungs
Deep vein thrombosis (DVT), often affecting the legs
Thicker blood moves more slowly, allowing clots to form more easily, particularly in those who are inactive or have other cardiovascular risk factors.
Bleeding
Ironically, people with polycythaemia vera (a form of erythrocytosis) may also be at risk of bleeding, especially from:
Nosebleeds
Gum bleeding
Gastrointestinal bleeding
This is due to abnormalities in platelet function, even when platelet counts are high.
High Blood Pressure
Increased blood volume and thickness can raise blood pressure, straining the heart and blood vessels. This further raises the risk of stroke and heart disease.
Gout and Kidney Stones
High cell turnover can lead to increased uric acid levels, resulting in:
Gout attacks, causing painful joint swelling
Kidney stones, due to crystallised uric acid in the urine
Progression to Myelofibrosis or Leukaemia
In rare cases of polycythaemia vera, prolonged bone marrow stimulation can lead to:
Myelofibrosis, where scar tissue replaces bone marrow
Acute leukaemia, a serious blood cancer
These complications are more likely in long-standing or poorly managed cases.
Complications of Erythrocytosis In South Africa
In South Africa, complications are more likely in undiagnosed or untreated patients. Those with limited healthcare access may present late with stroke or DVT. Public education and regular screening for high haematocrit levels can help reduce the burden of undiagnosed erythrocytosis.
Patients with lung disease, especially in mining areas or high-altitude regions, should be monitored closely for signs of elevated red blood cell counts.
The complications of erythrocytosis can be life-threatening, but most are preventable. With early diagnosis, proper monitoring, and appropriate treatment, patients can lead long, healthy lives.
