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Which red cell diseases produce a hyperviscosity state?
Polycythemia rubra vera and “secondary” or “relative” polycythemia increase the hematocrit or the red cell volume/plasma volume ratio, respectively.
These conditions thereby increase blood viscosity, producing symptoms.
Either chronic reduction in hematocrit by phlebotomy or acute expansion of the plasma volume both reduce symptoms and may decrease the risk of serious sequelae.
Sources
- Aminoff MJ: Neurologic complications of systemic disease. In Bradley WG, Daroff RB, Fenichel G, Jankovic J (eds): Neurology in clinical practice, 3rd ed. Boston, Butterworth-Heinemann, p 1020, 2000.
- Adams RJ, McKie VC, Hsu L, et al.: Prevention of a first stroke by transfusions in children with sickle cell anemia and abnormal results on transcranial Doppler ultrasonography. N Engl J Med 339:5-11, 1998.
- Prengler M, Pavlakis SG, Prohovnik I, Adams RJ: Sickle cell disease: the neurological complications. Ann Neurol 51:543-552, 2002.
- Debaun MR, Armstrong FD, McKinstry RC, Ware RE, Vichinski E, Kirkham FJ: Silent cerebral infarcts: a review on a prevalent and progressive cause of neurologic injury in sickle cell anemia. Blood 119(20):4587-4596, 2012.
