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Forum Name: Hematology Topics

Question: Can Hemochromatosis cause Polycythemia


 Tw00sh - Sun Dec 28, 2008 11:20 am

Hi, I am a 38 year old male with a high ferratin and high hemoglobin count. I get regular phlebotomies at least once a month and been undergoing this treatment for about a year now.

I was first diagnosed with high blood pressure and then under a long process to track down the reason for this It was determined I had Hemochromatosis heterozygous. I went under a pretty aggressive phlebotomy process to get my ferratin level below 50.

I recently moved to a new state and started to see a new hematologist. This hematologist determined I had a high hemoglobin count and that I may not have had Hemochromatosis but instead Polycythemia. I have had several blood tests, colonoscopy, ultra sounds on my liver and kidneys, eye exams, and echocardiogram. I am scheduled for a sleep study to determine if this is a respiratory problem. All the tests results have come back normal thus far. I have been told I have Polycythemia Secondary, but no diagnosis as to what is causing it.

Is it possible I was originally diagnosed correctly with Hemochromatosis and this deasease can be causing an increase in Red Blood Cells as well? Should I request to see a new hematologist?
 John Kenyon, CNA - Tue Dec 30, 2008 11:06 pm

User avatar Hello -

I've done some research based on your post, and have been able to find only conflicting information, but most of it has argued against a connection between Polycythemia and HH. There is at least one case on record that I was able to find, so it's clearly not impossible, but apparently this is extremely unusual. On the other extreme there are several studies which flatly state there is "no connection" between the two conditions. Based on my admittedly limited understanding of hemotology, it seems not unreasonable that polycythemia could occur secondary to HH, but apparently it doesn't happen very often.

Since this is well outside the scope of my training and knowlege, I will refer this to our site's hematology team in hopes someone can come up with a better answer for you. Meanwhile, good luck to you with this, and please follow up as needed.
 Tw00sh - Fri Jan 02, 2009 12:38 am

Thank you for your response.

I do not seem to have a diagnoses for the Polycythemia Secondary yet. The hematologist basically has not been able to discover a cause for my increase in red blood cells. I might have new information after taking a sleep study to determine if I have a form of sleep apnea, but I do not feel this is the cause as I have no sleeping disorders I am aware of.

Are there any cases of individuals just having an increase in red blood cells for no apprarent reason? Can this just be the way I am, or does this condition have to be caused by something?
 John Kenyon, CNA - Fri Jan 02, 2009 11:32 am

User avatar You're welcome.

While I'm unaware (and I've been looking through the literature) of any aspect of HH that would cause any significant increase in red cell production, I've found one case of a young man who actually has both conditions simultaneously and, according to his doctors, utterly independent of one another. While this is apparently extremely rare, it's the only thing that comes to mind, assuming the red cell increase is significant and consistent. The by far greatest balance of studies all argue there is no "secondary" develpment of polycythemia via HH because there is no connection between the two. At least that's what's believed today. Then again, your current hematologist seems to believe it's possible, and he has to have based that notion (absent an actual diagnosis) on something he believes to be sound.

It is certainly conceivable that a mild increase in red cells, transiently, could be caused by something incidental and not pathogenic. If the count is markedly raised, however, over a period of time, something else must be going on.

I guess we'll see in time. Please keep us updated.

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