Polycythemia: a mystery solved by history

Authors

  • Chetan Kalal Department of Gastroenterology, Sir H. N. Reliance Hospital and Research Centre, Mumbai, Maharashtra, India
  • Atif Patel Department of Gastroenterology, Sir H. N. Reliance Hospital and Research Centre, Mumbai, Maharashtra, India
  • Adinath Wagh Department of Gastroenterology, Sir H. N. Reliance Hospital and Research Centre, Mumbai, Maharashtra, India
  • Harshad Joshi Department of Gastroenterology, Sir H. N. Reliance Hospital and Research Centre, Mumbai, Maharashtra, India
  • Samit Jain Department of Gastroenterology, Sir H. N. Reliance Hospital and Research Centre, Mumbai, Maharashtra, India
  • Ravindra Surude Department of Gastroenterology, Sir H. N. Reliance Hospital and Research Centre, Mumbai, Maharashtra, India
  • Shobna Bhatia Department of Gastroenterology, Sir H. N. Reliance Hospital and Research Centre, Mumbai, Maharashtra, India
  • Chetan Bhatt Department of Gastroenterology, Sir H. N. Reliance Hospital and Research Centre, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20204266

Keywords:

Polycythemia, Testosterone induced polycythemia, Androgenic-anabolic steroids

Abstract

Testosterone is responsible for increased muscle mass. Leaner body mass helps control weight and increases energy. High levels of testosterone help build muscles and also stimulate growth in strength. Androgenic-anabolic steroids (AAS) are drugs that are structurally related to the cyclic steroid rings system and have similar effects to testosterone in the body. Athletes who abuse steroids do so for muscle growth and quick recovery. Testosterone - whether it's injected, applied via a patch or cream, or taken orally - allows athletes to rapidly increase muscle mass beyond their usual capacity, and also reduces their recovery time which allows them to train continuously with little need to rest their bodies in between workouts. Physiologically, erythrocytosis is defined by an erythrocyte mass that exceeds 125% of that predicted for sex and body mass. Much of the concern with the use of testosterone involves increase in blood viscosity, resulting from increased red blood cell mass causing a potential increased risk for venous thromboembolism (VTE), myocardial infarction (MI), and cerebrovascular accidents (CVA). We report a case of secondary polycythemia related to testosterone therapy.

References

Keohane C, McMullin MF, Harrison C. The diagnosis and management of erythrocytosis. BMJ. 2013;347.

Brækkan SK, Mathiesen EB, Njølstad I, Wilsgaard T, Hansen JB. Hematocrit and risk of venous thromboembolism in a general population. The Tromsø study. Haematologica. 2010;95(2):270-5.

Nadeem O, Gui J, Ornstein DL. Prevalence of venous thromboembolism in patients with secondary polycythemia. Clin Appl Thromb. 2013;19(4):363-6.

Morales A, Bebb RA, Manjoo P, Assimakopoulos P, Axler J, Collier C, et al. Diagnosis and management of testosterone deficiency syndrome in men: Clinical practice guideline. CMAJ. 2015;187(18):1369-77.

Barbui T, Thiele J, Vannucchi AM, Tefferi A. Rationale for revision and proposed changes of the WHO diagnostic criteria for polycythemia vera, essential thrombocythemia and primary myelofibrosis. Blood Cancer J. 2015;5(8):337.

Mirand EA, Gordon AS, Wenig J. Mechanism of testosterone action in erythropoiesis. Nature. 1965;206(4981):270-2.

Coviello AD, Kaplan B, Lakshman KM, Chen T, Singh AB, Bhasin S. Effects of graded doses of testosterone on erythropoiesis in healthy young and older men. J Clin Endocrinol Metab. 2008;93(3):914-9.

Blanchard KL, Acquaviva AM, Galson DL, Bunn HF. Hypoxic induction of the human erythropoietin gene: cooperation between the promoter and enhancer, each of which contains steroid receptor response elements. Mol Cell Biol. 1992;12(12):5373-85.

Bhasin S, Cunningham GR, Hayes FJ, Matsumoto AM, Snyder PJ, Swerdloff RS, et al. Testosterone therapy in men with androgen deficiency syndromes: An endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2010;95(6):2536-59.

EAU Guidelines: Male Hypogonadism | Uroweb. https://uroweb.org/guideline/male-hypogonadism/. Accessed September 23, 2020.

Downloads

Published

2020-09-24

How to Cite

Kalal, C., Patel, A., Wagh, A., Joshi, H., Jain, S., Surude, R., Bhatia, S., & Bhatt, C. (2020). Polycythemia: a mystery solved by history. International Journal of Research in Medical Sciences, 8(10), 3746–3748. https://doi.org/10.18203/2320-6012.ijrms20204266

Issue

Section

Case Reports