From the Research
For elevated hemoglobin (Hgb) levels, follow-up testing should include a complete blood count with differential, serum erythropoietin level, and JAK2 V617F mutation testing to evaluate for polycythemia vera, as recommended by the most recent and highest quality study 1. The diagnosis and management of polycythemia vera, a myeloproliferative neoplasm characterized by an increased red blood cell mass, is crucial to prevent complications such as thrombosis. Key tests to consider include:
- Complete blood count with differential to assess all blood cell lines
- Serum erythropoietin level to evaluate for secondary causes of erythrocytosis
- JAK2 V617F mutation testing to confirm the diagnosis of polycythemia vera
- Arterial blood gas analysis to check oxygen saturation
- Comprehensive metabolic panel to assess organ function
- Abdominal ultrasound to examine spleen size If secondary polycythemia is suspected, additional tests such as pulmonary function tests and sleep studies may be warranted to identify underlying cardiopulmonary causes. The timing of follow-up depends on the degree of elevation, with moderate elevations requiring reassessment in 1-3 months and significant elevations (Hgb >18.5 g/dL in men or >16.5 g/dL in women) warranting more urgent evaluation to prevent complications like thrombosis, as supported by the latest evidence 1.