Differential Diagnosis for Elevated Red Blood Cell Count and Hematocrit
Single Most Likely Diagnosis
- Dehydration: This is the most common cause of elevated red blood cell count and hematocrit due to a decrease in plasma volume, which concentrates the red blood cells.
Other Likely Diagnoses
- Chronic Hypoxia: Conditions such as chronic obstructive pulmonary disease (COPD), sleep apnea, or living at high altitudes can lead to increased erythropoietin production, stimulating red blood cell production.
- Polycythemia Vera: A myeloproliferative disorder characterized by the overproduction of red blood cells, white blood cells, and platelets.
- Testosterone Replacement Therapy: Exogenous testosterone can stimulate erythropoiesis, leading to an increase in red blood cell count and hematocrit.
Do Not Miss Diagnoses
- Renal Cell Carcinoma: Some renal cell carcinomas can produce erythropoietin, leading to secondary polycythemia.
- Cerebellar Hemangioblastoma: These tumors can also produce erythropoietin, causing an increase in red blood cell count and hematocrit.
Rare Diagnoses
- Erythropoietin-Producing Tumors: Rare tumors such as hepatocellular carcinoma, pheochromocytoma, or uterine leiomyoma can produce erythropoietin, leading to elevated red blood cell count and hematocrit.
- Congenital Polycythemia: A rare genetic disorder characterized by an increase in red blood cell mass due to mutations in the erythropoietin receptor or other genes involved in erythropoiesis.