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The Intern At Work: Internal Medicine

218. From Leeches to Personalized Medicine - Approaches to Polycythemia Vera and Essential Thrombocythemia

Dec 10, 2023
From the rise and fall of bloodletting in the 19th century to the current use of precision medicine, this podcast explores polycythemia vera and essential thrombocytosis. It covers the prevalence, characteristics, and complications of polycythemia vera, along with the diagnostic criteria and treatment options. The podcast also delves into essential thrombocythemia, discussing its diagnosis, causes, and management. Risk stratification and historical treatment approaches are explored, including the use of bloodletting.
13:20

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Quick takeaways

  • Polycythemia vera is characterized by excessive production of red blood cells and the presence of Jack 2 mutation.
  • When diagnosing erythrocytosis, it is important to differentiate primary causes like PV from secondary causes and assess symptoms like pruritus and erythromelalgia.

Deep dives

History and diagnosis of polycythemia vera

Polycythemia vera (PV) is the most common form of myeloproliferative disorder, characterized by excessive production of red blood cells. Almost all patients with PV have a Jack 2 mutation, which leads to activation of the Jack/STAT pathway and increased cell proliferation. Diagnosis of PV requires meeting specific criteria including elevated hemoglobin levels, bone marrow biopsy findings, and the presence of Jack 2 mutation.

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