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Are low reticulocytes (immature red blood cells) common with PV?

A myMPNteam Member asked a question 💭

Hi there! I have been struggling to get a diagnosis for some time. My hemoglobin, erythrocytes, and hematocrit are high, but my reticulocytes and RDW are very low. Has anyone else experienced this pattern or have an idea what it might point to? Thanks so much for any advise!

January 25
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myMPNteam

Are low reticulocytes common with polycythemia vera when hemoglobin, erythrocytes, and hematocrit are high?

In polycythemia vera, blood work typically shows high values for red blood cell count, hemoglobin level, and hematocrit levels - which matches what you're experiencing. PV is often discovered during routine blood Show Full Answer

Are low reticulocytes common with polycythemia vera when hemoglobin, erythrocytes, and hematocrit are high?

In polycythemia vera, blood work typically shows high values for red blood cell count, hemoglobin level, and hematocrit levels - which matches what you're experiencing. PV is often discovered during routine blood tests showing these abnormally high quantities of red blood cells.

One key diagnostic feature of PV is decreased erythropoietin (EPO) levels. EPO is the hormone that normally stimulates red blood cell production. When EPO is low, your bone marrow produces fewer new red blood cells, which could explain why your reticulocytes (immature red blood cells) are low even though your overall red blood cell count is high.

In PV, the bone marrow produces too many mature red blood cells due to abnormal precursor cells that are overly sensitive to EPO. This happens even with low EPO levels, which is part of what makes PV different from other causes of high red blood cell counts.

Your specific pattern of high hemoglobin/hematocrit with low reticulocytes could be consistent with PV, but diagnosis requires additional testing including bone marrow biopsy, tests for JAK2 gene mutations (found in almost all PV cases), and measuring EPO levels.

It's important to discuss these results with your doctor, who can order the appropriate diagnostic tests to determine whether this is PV or another condition.

January 25

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