Polycythemia Rubra vera-Clinical Profile & Predictors of Thrombotic Complications

Polycythemia rubra vera (PRV) is a myeloproliferative disorder, with significant risk for thrombotic complications [1]. The study was an attempt to highlight the clinical and hematological profile of the disease in Indian population sampled from a tertiary care centre of Northern Kerala and to probe into the possible predictors of thrombotic events. Of the 37 cases, males constituted 73% and their mean age at diagnosis was 57 years. A few findings contradicted the clinical utility of 2008 WHO criteria for the diagnosis of PRV. 18.9% of the subjects had hemoglobin level less than the WHO cut off and splenomegaly was absent in another 18.9% of the cases, who were all JAK-2 positive and had symptoms of polycythemia. Thrombotic complications occurred in 35.1% of the subjects. Predictors of thrombosis included higher hemoglobin levels (19.4g% vs 18.6g%; P:0.026), high total leukocyte counts (17600/mm3 vs 11700/mm3; P:0.001) and elevated uric acid levels (8.31mg/dl vs 6.78 mg/dl; P:0.001). Subjects with more consumption of fruits, vegetables and pulses had a significantly lower risk of thrombotic events (P:0.01).