Polycythaemia Rubra Vera (PRV)

Patients with PRV have over production of red blood cells with in the bone marrow and as a result haemoglobin, red cell mass and haematocrit are all raised. Bone marrow examination reveals a hypercellular marrow. Remember in apparent polycythaemia there is a reduced plasma volume and raised haematocrit but there is a normal red cell mass. As a result of the increased turnover of cells, urate rises and these patients not uncommonly report symptoms of gout. Erythropoietin levels are LOW in PRV as the raised haemoglobin negatively feeds back on erythropoietin production.