What is Polycythemia Rubra Vera?

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  • Written By: Mary McMahon
  • Edited By: Nancy Fann-Im
  • Last Modified Date: 17 October 2018
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Polycythemia rubra vera is an increase in the volume of red blood cells in proportion to plasma products. This condition can take a number of forms, and causes range from benign quirks of genetics to malignancies in the bone marrow. A patient with this medical issue may experience symptoms like fatigue, headache, difficulty breathing, and chest pains. A quick blood test can determine that the proportion of red blood cells in the blood is off and will often provide information about why.

In absolute polycythemia rubra vera, the patient is making more red blood cells than usual. White blood cells may also be elevated. Patients with the relative form of this condition have reduced plasma levels, causing it to look like they have more red blood cells. A doctor can conduct a patient interview to determine possible causes and discuss treatments. One potential treatment is therapeutic phlebotomy to remove some of the extra red blood cells, and it may be possible to donate them for use in blood transfusions.


Absolute polycythemia rubra vera can be the result of genetic conditions, adaptations to chronic low oxygen levels, tumors, and cancers. The doctor can run some tests and look for risk factors like a lot of time spent at high altitudes, which would suggest the condition is a benign adaptation, not evidence of malignancy. Athletes who train in mountainous regions, for example, often have polycythemia rubra vera. The doctor will check on levels of other blood products and ask about symptoms like bone and joint pain, which might indicate a more serious problem.

Relative polycythemia rubra vera is usually the result of a temporary drop in body fluids. People with dehydration can experience this as a symptom, as can burn victims, who often lose a lot of plasma while their bodies recover. Some smokers also experience drops in blood plasma. The treatment is usually restoration of fluids, taking care to use fluids with an appropriate salt balance to avoid complications.

For some patients, polycythemia rubra vera is a chronic health issue. They will need regular monitoring and treatment to keep their red blood cells within a safe range. In others, it may be constantly present without posing a threat, and it is important to make sure the condition is noted in patient charts. This will prevent situations where new care providers think the increase in red blood cells is a new and worrying symptom in a patient.


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