PV

LOW

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Diagnostic for PV

PV

Nondiagnosic for PV

Repeat Hb in 3 months

Obtain bone marrow

Hb >18.5 g/dL (m)

>16.5 g/dL (f)

Secondary
erythrocytosis

INCREASED

04/2013

Secondary erythrocytosis

POSITIVE

Repeat Hb in
3 months

Hb <18.5 g/dL (m)

<16.5 g/dL (f)

NORMAL

Workup for secondary

erythrocytosis
NEGATIVE

Repeat EPO and

Hb in 3 months

Nondiagnostic for PV

Obtain bone marrow

Diagostic for PV

Repeat EPO and

Hb in 3 months

NEGATIVE

* PV-related features include portal vein thrombosis, Budd-Chiari syndrome,

splenomegaly, erythromelalgia, persistent leukocytsis, thrombocytosis, or
microcytosis, post-bath pruritus, and digital ischemia.

PV

POSITIVE

Obtain EEC study (research use only)

PV

PV

Nondiagnostic for PV

Obtain bone marrow

NORMAL

Diagostic for PV

Secondary
erythrocytosis

LOW

Check EPO

Check EPO
INCREASED

PV-related features* absent

PV-related features* present

Suspected erythrocytosis

Diagnostic Approach to Suspected Erythrocytosis