Acute pancreatitis and relative polycythaemia: a case series
Keywords:Acute necrotizing pancreatitis, Relative polycythaemia, Haem concentration
Relative polycythaemia is an apparent rise in erythrocyte level in the blood. However, the underlying cause is reduced blood plasma. Relative polycythaemia is often caused by loss of body fluids seen in conditions such as burns, dehydration and stress manifesting itself as a raised Haemoglobin or haematocrit. This case series presents a clinical summary of three patients with acute pancreatitis (AP) and relative polycythaemia due to reduction in plasma volume as a result of intravascular volume depletion as demonstrated by increase in haemoglobin and haematocrit. Haem concentration may be considered as a marker for acute severe pancreatitis and correcting the volume depletion by adequate fluid improves the outcome of AP as seen in all our three patients.
Halonen KI, Leppniemi AK, Puolakkainen PA, Lundin JE, Kemppainen EA, Hietaranta AJ, et al. Severe Acute Pancreatitis: Prognostic Factors in 270 Consecutive Patients: Pancreas. 2000;21(3):266-71.
Forsmark CE, Baillie J. AGA Institute Technical Review on Acute Pancreatitis. Gastroenterology. 2007;132(5):2022-44.
Lankisch PG, Mahlke R, Blum T, Bruns A, Bruns D, Maisonneuve P, et al. Hemoconcentration: an early marker of severe and/or necrotizing pancreatitis? A critical appraisal. Am J Gastroenterol. 2001;96(7):2081-5.
Brown A, Orav J, Banks PA. Hemoconcentration Is an Early Marker for Organ Failure and Necrotizing Pancreatitis: Pancreas. 2000;20(4):367–72.
Venkat SK, Sattar R, Kumar D. An unusual case of relative polycythemia with complication of pseudocyst of pancreas. Int Surg J. 2017;4(2):816.
Hsi ED. Hematopathology E-Book: a Volume in the Series: Foundations in Diagnostic Pathology. Philadelphia: Elsevier Health Sciences; 2017. Available at: https://public.ebookcentral.proquest. com/choice/publicfullrecord.aspx?p=5253029. Accessed on 4 June 2020.
Sahin M, Cindoruk M, Sen I, Utku OG. An unusual case of polycythemia vera with a complication of pancreatic pseudocyst. Turk J Gastroenterol. 2012;23(5):623–5.
Sabiston DC, Townsend CM (Eds.). Sabiston textbook of surgery: the biological basis of modern surgical practice. Philadelphia, PA: Elsevier Saunders, 2019.