Plethora or a ruddy complexion is characteristic of PV and results from the marked increase in total red blood cell mass. This manifests in the face, palms, nailbeds, mucosa, and conjunctiva.
Splenomegaly is present in 75% of patients at the time of diagnosis. Hepatomegaly is present in approximately 30% of patients. Early satiety can occur in patients with splenomegaly because of gastric filling being impaired by the enlarged spleen or, rarely, as a symptom of splenic infarction. Weight loss may result from early satiety or from the increased myeloproliferative activity of the abnormal clone.
Hypertension is common in patients with PV. Measurement of the red blood cell mass should differentiate this condition from Gaisbock syndrome, which is hypertension and pseudopolycythemia (ie, high hemoglobin levels due to low plasma volume).
For more on the presentation and physical examination of patients with PV, read here.
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Cite this: Emmanuel C. Besa. Fast Five Quiz: Are You Familiar With Key Aspects of Polycythemia Vera? - Medscape - Apr 04, 2018.