High Red Blood Cells: Causes, Symptoms, Diagnosis, Treatment and Outlook

Erythrocytosis is the condition that affects the individual when there is a high red blood cell count.

This is a condition where your body makes too many red blood cells ( erythrocytes ). Red blood cells carry oxygen to your organs and tissues. Too many partitions can make your blood thicker than usual and lead to blood clots and other complications.

There are two types of erythrocytosis:

  • Primary erythrocytosis is caused by a problem with cells in the bone marrow, where red blood cells are made. Primary erythrocytosis is sometimes inherited.
  • Secondary erythrocytosis: a disease or the use of certain drugs that can cause this type.

Between 44 and 57 out of 100,000 people have primary erythrocytosis, according to a 2013 review of the condition. The number of people with secondary erythrocytosis may be higher, but it is difficult to get an exact number because many possible causes exist.

Erythrocytosis is sometimes referred to as polycythemia, but the conditions are slightly different:

  • Erythrocytosis is an increase in red blood cells about the volume of blood.
  • Polycythemia increases the concentration of red blood cells and hemoglobin, the protein in red blood cells that carries oxygen to the body’s tissues.

What Causes High Red Blood Cells?

Primary erythrocytosis can be passed down through families. It is caused by a gene mutation that controls how many red blood cells the bone marrow makes. When one of these genes is mutated, your bone marrow will make extra red blood cells, even when your body doesn’t need them.

Another cause of primary erythrocytosis is polycythemia vera. This disorder causes your bone marrow to make too many red blood cells. Your blood becomes very thick as a result.

“In the case of congenital syndromes, MPV is increased in Bernard-Soulier Syndrome, Epstein Syndrome, and Gray Platelet Syndrome, which are scarce clinical situations.”

Secondary erythrocytosis increases red blood cells caused by an underlying disease or certain medications.

Causes of secondary erythrocytosis include:

  • Smoke.
  • Lack of oxygen, such as lung disease or being at high altitudes.
  • Tumors
  • Medications such as steroids and diuretics.

Sometimes the cause of secondary erythrocytosis is unknown.

What are the symptoms?

Symptoms of erythrocytosis include:

  • Headaches.
  • Dizziness.
  • Difficulty breathing.
  • Nosebleeds
  • Elevation of blood pressure.
  • Blurry vision.
  • Itch.

Having a high red blood cell count can also increase your risk of blood clots. If a clot lodges in an artery or vein, it can block blood flow to essential organs like the heart or brain. A blockage in blood flow can lead to a heart attack or stroke.

How are high red blood cells diagnosed?

Your doctor will start by asking about your medical history and symptoms. They will then do a physical exam.

Blood tests may measure your red blood cell count and erythropoietin (EPO) levels. EPO is a hormone released by your kidneys. Increases red blood cell production when your body is low on oxygen.

People with primary erythrocytosis will have a low EPO level. Those with secondary erythrocytosis may have a high EPO level.

You may also have blood tests to check the levels of:

  • Hematocrit – This is the percentage of red blood cells in your blood.
  • Hemoglobin: This is the protein in red blood cells that carries oxygen throughout the body.

A test called pulse oximetry measures the amount of oxygen in your blood. It uses a clip device that is attached to your finger. This test can show if a lack of oxygen caused your erythrocytosis.

If your doctor thinks there might be a problem with your bone marrow, they will likely test for a gene mutation called JAK2. You may also need a bone marrow aspiration or biopsy.

This test removes a sample of tissue, fluid, or both from inside the bones. It is then tested in a lab to see if your bone marrow makes too many red blood cells.

You can also be tested for the genetic mutations that cause erythrocytosis.

Treatment and management of high red blood cells

Treatment is aimed at reducing the risk of blood clots and relieving symptoms. It often involves reducing the red blood cell count.

Treatments for erythrocytosis include:

  • Phlebotomy (venesection): This procedure removes a small amount of blood from your body to decrease the number of red blood cells. You may need to undergo this treatment twice a week or more until your condition is under control.
  • Aspirin:  Taking low doses of this pain reliever daily can help prevent blood clots.
  • Drugs that reduce RBC production include hydroxyurea (Hydrea), busulfan (Myleran), and interferon.

What is the perspective?

Often, the conditions that cause erythrocytosis cannot be cured. Without treatment, erythrocytosis can increase the risk of blood clots, heart attack, and stroke.

It can also increase your risk of leukemia and other types of blood cancer.

Getting treatment that lowers the number of red blood cells your body makes can reduce your symptoms and prevent complications.