Clinical reference

Benign or uncertain blood-related neoplasm (including polycythaemia vera)

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class BD26 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care · Polycythemia Vera - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK557660/

Verified against1 document

No dose - referral pathway, no medicine given in primary care

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (6)

Complaints: tiredness, headache, dizziness, ringing in the ears, altered vision, poor sleep, calf pain on walking, itch, gastritis, filling up quickly [claudication · dizziness · fatigue · headache · insomnia · itching · tinnitus]
Itch that starts during or soon after a hot shower troubles 40% of patients [itching]
Burning pain in hands and feet, either reddened or pale [burning pain · pallor · redness]
Bleeding shows as nosebleeds, bleeding gums, or blood loss from the gut [bleeding · gum bleeding · nosebleed]
Clots show as DVT, pulmonary embolism, Budd-Chiari, splanchnic vein thrombosis, stroke, arterial thrombosis
Filling up early comes from a big spleen limiting how much the stomach holds

Signs — what you find (2)

Ruddy flushed face and palms, red eyes, and scratch marks over the skin
An enlarged spleen and liver are often found [splenomegaly]

Tests (8)

In men haemoglobin above 16.5 g/dL or haematocrit above 49%; in women above 16 g/dL or above 48%
Alternatively a red cell mass more than 25% above the predicted normal mean
Marrow biopsy: too many cells for age, growth across all three lines, with varied mature megakaryocytes
A JAK2 V617F or exon 12 mutation is the third major criterion
The minor criterion is a serum erythropoietin under the normal range
Diagnosis needs all three major criteria, or two major plus the minor one
Apply the criteria only once secondary causes have been excluded
True polycythaemia vera needs raised output in all three cell lines

If not this — what else fits (5)

Secondary polycythaemia from low oxygen or smoking is far commoner and must be excluded first
A raised red cell mass alone is not diagnostic; chronic hypoxia and EPO-secreting tumours do it too
A rare EPO-receptor mutation copies the picture, with high red cell mass and low EPO
Granulocytosis alone follows infection or a leukaemoid reaction; a lone high platelet count follows bleeding or iron lack
Other myeloid neoplasms: essential thrombocythaemia, CML, agnogenic myeloid metaplasia, primary myelofibrosis

SourceStatPearls "Polycythemia Vera" - disease-level clinical article

Presentation findings are traced to the source above.

NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)

1st line

Adult dose and duration

Includes polycythaemia vera, diagnosed and managed by haematology (phlebotomy, cytoreductive therapy); a GP refers for diagnosis and may continue low-dose aspirin for clot prevention once a haematologist has established the diagnosis and plan. - Refer, with advice

Paediatric dose

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

Dose source

No dose - referral pathway, no medicine given in primary care

Why

Cautions

No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.
RED FLAG - Facial plethora with itching after a hot bath (polycythaemia vera), thrombosis or stroke-like symptoms, a very high haemoglobin or haematocrit on routine bloods, or splenomegaly: assess urgently and refer.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.