20.500.12556/RUL-165014 Obravnava bolnikov z neklonsko eritrocitozo Management of patients with non-clonal erythrocytosis Eritrocitoza je stanje povečane skupne mase eritrocitov, ki se pojavi zaradi zelo heterogenih vzrokov. Bolniki so lahko brez simptomov ali pa imajo simptome in znake povečane viskoznosti krvi. Pri obravnavi bolnika z eritrocitozo uporabljamo diagnostični algoritem, ki omogoča opredelitev vzroka eritrocitoze in ustreznega zdravljenja. V prvem koraku potrjujemo absolutno eritrocitozo s koncentracijo hemoglobina (Hb) > 185 g/L in/ali hematokritom (Ht) > 0,52 za moške ter s Hb > 165 g/L in/ali Ht > 0,48 za ženske. V drugem koraku hkrati izključujemo pravo policitemijo in iščemo sekundarne pridobljene vzroke eritrocitoze, kot so bolezni pljuč, srca, ledvic, tumorji z neustreznim izločanjem eritropoetina. Omeniti velja, da je po smernicah Svetovne zdravstvene organizacije (SZO) diagnosticiranje prave policitemije ob ustrezni klinični sliki določeno že pri nižjih vrednostih, natančneje ob Hb > 165 g/L ali Ht > 0,49 za moške ter Hb > 160 g/L ali Ht > 0,48 za ženske. V tretjem koraku bolnike, ki nam jih ni uspelo opredeliti kljub natančnim diagnostičnim preiskavam, napotimo na genetsko testiranje za opredelitev prirojene eritrocitoze. Ko izključimo pravo policitemijo, sekundarno pridobljeno in prirojeno eritrocitozo, ostane skupina oseb s t. i. idiopatsko eritrocitozo. Priporočeno zdravljenje je odvisno od vzroka eritrocitoze, najpogosteje pa vključuje jemanje acetilsalicilne kisline in ustrezno zniževanje hematokrita z venepunkcijami ob rednih kontrolah krvne slike. Erythrocytosis is a condition of increased red cell mass and has a very heterogeneous etiology. Patients may be asymptomatic or have symptoms and signs of increased blood viscosity. A diagnostic algorithm is applied to confirm the precise etiology necessary for appropriate treatment. In the first step, we have to confirm absolute erythrocytosis with hemoglobin (Hb) > 185 g/L and/or hematocrit (Ht) > 0.52 for men and Hb > 165 g/L and/or Ht > 0.48 for women. In the second step, we exclude polycythaemia vera and also search for secondary acquired causes such as lung-, heart- and kidney diseases and tumours with exogenous erythropoietin secretion. It is worth mentioning that according to the WHO guidelines, the diagnosis of polycythaemia vera in patients with an appropriate clinical picture is indicated at lower values, more precisely, Hb > 165 g/L or Ht > 0.49 for men and Hb > 160 g/L or Ht > 0.48 for women. In the third step, we refer patients without a known cause of erythrocytosis for genetic testing to identify congenital erythrocytosis. People in whom we have excluded polycythaemia vera, secondary acquired and congenital erythrocytosis, have idiopathic erythrocytosis. Treatment depends on the cause of the erythrocytosis. Most commonly, it includes acetylsalicylic acid and venipunctures. absolutna eritrocitoza sekundarna eritrocitoza prirojena eritrocitoza eritropoetin tromboze absolute erythrocytosis secondary erythrocytosis congenital erythrocytosis erythropoietin thrombosis true false true Slovenski jezik Angleški jezik Članek v reviji 2024-11-21 06:42:28 2024-11-21 06:42:31 2025-11-12 15:04:39 0000-00-00 00:00:00 2023 0 0 Str. 173-181 št. 3/4 Letn. 92 2023 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 616.155.12 1318-0347 10.6016/ZdravVestn.3369 151227395 RAZ_Drnovsek_Eva_2023.pdf RAZ_Drnovsek_Eva_2023.pdf 1 DBE3CBA477BBD3145D811F5024BDA908 8634023fd09e4aef13dd54defcc8c33d52f662204b974eb1811bc391f5a998eb 73692048-a7cb-11ef-b232-0050569b8976 https://repozitorij.uni-lj.si/Dokument.php?lang=slv&id=195928 https://vestnik.szd.si/index.php/ZdravVest/article/view/3369 0 2c6dfedf-bfcd-11f0-9328-0050569b8976 https://repozitorij.uni-lj.si/Dokument.php?lang=slv&id=221819 Medicinska fakulteta 0 0 0