Symptoms

What symptoms and complications can occur?

Not every patient has symptoms in the early stage of the disease. They can vary between individuals, including in terms of their severity, and often change over the course of the disease.

PV is sometimes only discovered by chance with a routine blood count, which reveals an elevated haematocrit and/or haemoglobin level.

Viscous blood and circulatory disorders – the most common causes of symptoms

Symptoms quite often come about due to the blood being viscous and the increased volume. They include a reddened complexion, blue/red discolouration of the skin, headaches and an increased blood pressure level (hypertension).

Patients may also experience circulatory disturbances in the form of problems with vision, numbness or painful reddening, swelling, an itching or burning sensation in the toes and fingers (erythromelalgia), above all when exposed to heat. Dizziness and tinnitus, cramp in the calf muscles or joint and bone pain sometimes also occur here.

If the number of platelets is greatly increased, patients may additionally experience bleeding of the nose and gums.

The most common symptoms

As many as 90% of patients with PV complain of chronic fatigue and up to 70% of itching (pruritus), which can be almost unbearable. This is triggered in many cases by contact with water, e.g. hot baths/showers (known as aquagenic pruritus). Night sweats are also common here. Symptoms affecting the upper abdomen can be caused by enlargement of the spleen (splenomegaly) as it increasingly takes on the task of blood formation, storage and breakdown, due to the bone marrow not functioning as it should.

Most of these symptoms cannot be identified for sure as PV at the outset but may well have other causes. Further tests by a specialist are thus necessary to make a definitive diagnosis of polycythaemia vera.