Polycythemia Vera in Children

Polycythemia vera is a very rare blood disorder in children. With
polycythemia vera, the bone marrow makes too many red blood cells. The extra cells make
the blood too thick. This may lead to blood clots. The clots can decrease the blood
supply to organs, tissues, and cells.

Genetic mutations in bone marrow cells cause polycythemia vera. Some
forms can be passed from parents to children. Some forms are not.

Some children do not have symptoms
and polycythemia vera may be found when they’re having blood tests for other reasons.
Symptoms occur more often in adults. 

Symptoms can occur a bit
differently in each child. They can include:

  • Headaches
  • Dizziness
  • Feeling weak and tired
  • Trouble breathing
  • Enlarged spleen
  • Trouble seeing
  • Itching or burning
  • Reddish coloring of face
  • Bleeding gums
  • Losing weight

The symptoms of polycythemia can be
like other health conditions. Make sure your child sees his or her healthcare provider
for a diagnosis.

The healthcare provider will ask about your child’s symptoms and health history. He or she will give your child a physical exam. Your child may also have tests, such as:

  • Hemoglobin and
    hematocrit. 
    This test measures the amount of hemoglobin and red blood
    cells in the blood.
  • Complete blood count (CBC).A complete blood count checks the red blood cells, white blood cells, blood
    clotting cells (platelets), and sometimes, young red blood cells (reticulocytes). It
    includes hemoglobin and hematocrit and more details about the red blood cells.
  • Peripheral smear.A small sample of blood is examined under a microscope. Blood cells are checked
    to see if they look normal or not.
  • Erythropoietin (EPO)
    level. 
    This test measures the amount of EPO in the blood. EPO is a
    hormone that helps make red blood cells.
  • Genetic tests. These tests
    look for gene mutations linked with polycythemia vera, such as JAK2, CALR and MPL, in
    addition to mutations in the EPO receptor.

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

Your child’s healthcare provider
will likely refer you to a hematologist, a specialist in blood disorders. Treatment may
include:

  • Venipuncture to remove some blood,
    which reduces the number of red blood cells (done like when a person donates
    blood)
  • Low-dose of aspirin to prevent blood clots
  • Medicines to decrease the production
    of red blood cells in the bone marrow
  • Other treatments that are being
    studied

Complications depend on how severe
the polycythemia is. They can include:

  • Blood clots in the veins of the liver
  • Deep vein thromboses or blood clots in the veins
  • Heavy bleeding
  • Stroke
  • Leukemia

Your child will be watched for changes in blood test results or signs
and symptoms of complications. Your child should stay out of extreme heat, like hot
baths. Heat may make some symptoms like itching and burning worse. And he or she should
stay away from sports and activities that are likely to cause injuries. Injuries may
increase the risk of bleeding.

Call your child’s healthcare
provider if you notice new or worse symptoms. For example, call if your child is more
tired than usual. Call your child’s healthcare provider or get medical care if your
child:

  • Is injured
  • Has pain in his or her arms or legs or
    abdomen (this may be from a blood clot)
  • Polycythemia vera is blood disorder in which the bone marrow produces too many red blood cells. The extra cells make the blood too thick, increasing the risk of blood clots.
  • Blood clots may cause serious problems depending on where they form. The clots can decrease the blood supply to the heart, brain, or liver, for example.
  • Treatment may include venipuncture to remove blood and taking aspirin.

Tips to help you get the most from a visit to your child’s healthcare provider:

  • Know the reason for the visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
  • Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
  • Ask if your child’s condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if your child does not take the medicine or have the test or procedure.
  • If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.