Determination of Serum Immunoreactive Erythropoietin in the Investigation of Erythrocytosis

We assessed the diagnostic value of determinations of serum levels of immunoreactive erythropoietin in 90 patients referred for the investigation of a raised packed red-cell volume (hematocrit) and possible erythrocytosis (a red-cell volume greater than that predicted by weight, body-surface area, o...

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Veröffentlicht in:The New England journal of medicine 1986-07, Vol.315 (5), p.283-287
Hauptverfasser: Cotes, P. Mary, Doré, Caroline J, Liu Yin, John A, Lewis, S. Mitchell, Messinezy, Maria, Pearson, Thomas C, Reid, Cecil
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container_start_page 283
container_title The New England journal of medicine
container_volume 315
creator Cotes, P. Mary
Doré, Caroline J
Liu Yin, John A
Lewis, S. Mitchell
Messinezy, Maria
Pearson, Thomas C
Reid, Cecil
description We assessed the diagnostic value of determinations of serum levels of immunoreactive erythropoietin in 90 patients referred for the investigation of a raised packed red-cell volume (hematocrit) and possible erythrocytosis (a red-cell volume greater than that predicted by weight, body-surface area, or both). The mean values for erythropoietin were 16 mlU per milliliter (range, 8 to 22) in patients with polycythemia rubra vera (n = 24),30-mlU per milliliter (range, 14 to 123) in patients with secondary erythrocytosis (n = 12), 27 mlU per milliliter (range, 13 to >400) in patients with erythrocytosis of unknown origin (n = 19), and 25 mlU per milliliter (range, 18 to 35) in normal controls (n = 25). The values in the patients with polycythemia rubra vera were lower than those in the other three groups (P
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Mary ; Doré, Caroline J ; Liu Yin, John A ; Lewis, S. Mitchell ; Messinezy, Maria ; Pearson, Thomas C ; Reid, Cecil</creator><creatorcontrib>Cotes, P. Mary ; Doré, Caroline J ; Liu Yin, John A ; Lewis, S. Mitchell ; Messinezy, Maria ; Pearson, Thomas C ; Reid, Cecil</creatorcontrib><description>We assessed the diagnostic value of determinations of serum levels of immunoreactive erythropoietin in 90 patients referred for the investigation of a raised packed red-cell volume (hematocrit) and possible erythrocytosis (a red-cell volume greater than that predicted by weight, body-surface area, or both). The mean values for erythropoietin were 16 mlU per milliliter (range, 8 to 22) in patients with polycythemia rubra vera (n = 24),30-mlU per milliliter (range, 14 to 123) in patients with secondary erythrocytosis (n = 12), 27 mlU per milliliter (range, 13 to &gt;400) in patients with erythrocytosis of unknown origin (n = 19), and 25 mlU per milliliter (range, 18 to 35) in normal controls (n = 25). The values in the patients with polycythemia rubra vera were lower than those in the other three groups (P&lt;0.01, P&lt;0.05, and P&lt;0.0001, respectively). In subjects with an increased packed red-cell volume but without erythrocytosis (n = 35), the levels of serum erythropoietin were the same as those in normal controls. Among patients with erythrocytosis with an unknown cause, abnormally high serum erythropoietin levels were found in 3 of 19 subjects, and in 1 of these 3 the abnormality was intermittent. Thus, measurement of serum erythropoietin in a single sample may be misleading and may not have high discriminatory value in distinguishing between polycythemia rubra vera and secondary erythrocytosis. This assay is useful in identifying patients with secondary erythrocytosis who have inappropriate erythropoietin secretion. (N Engl J Med 1986; 315:283–7.) THE differential diagnosis of erythrocytosis due to an unknown cause, after the exclusion of both polycythemia rubra vera and secondary erythrocytosis attributable to an associated disorder, can be a difficult problem. Estimates of erythropoietin by bioassays in vivo have an established place in the study of polycythemic states. 1 , 2 However, in vivo bioassays are not practical for large numbers of samples, sthey are expensive, and if the serum has a normal or low concentration of erythropoietin, a substantial sample volume must be concentrated before the assay. 2 In vitro bioassays that use cells in culture vary in specificity; in fact, published estimates . . .</description><identifier>ISSN: 0028-4793</identifier><identifier>EISSN: 1533-4406</identifier><identifier>DOI: 10.1056/NEJM198607313150503</identifier><identifier>PMID: 3724821</identifier><identifier>CODEN: NEJMAG</identifier><language>eng</language><publisher>Boston, MA: Massachusetts Medical Society</publisher><subject>Adult ; Aged ; Bioassays ; Biological and medical sciences ; Cell size ; Cloning ; Diagnosis, Differential ; Diseases of red blood cells ; Erythropoietin ; Erythropoietin - blood ; Female ; Hematocrit ; Hematologic and hematopoietic diseases ; Hematology ; Humans ; Hypoxia ; Male ; Medical sciences ; Middle Aged ; Patients ; Plasma ; Polycythemia ; Polycythemia - diagnosis ; Polycythemia - etiology ; Polycythemia Vera - diagnosis ; Polycythemias ; Serum levels</subject><ispartof>The New England journal of medicine, 1986-07, Vol.315 (5), p.283-287</ispartof><rights>1986 INIST-CNRS</rights><rights>Copyright Massachusetts Medical Society Jul 31, 1986</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c430t-cbaffd0b38715cf69a64b3de4ad15ea8c70f22a01f563db7b4c5a1853908bfd63</citedby><cites>FETCH-LOGICAL-c430t-cbaffd0b38715cf69a64b3de4ad15ea8c70f22a01f563db7b4c5a1853908bfd63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1880065130?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,777,781,27905,27906,64364,64366,64368,72218</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=8821513$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/3724821$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cotes, P. Mary</creatorcontrib><creatorcontrib>Doré, Caroline J</creatorcontrib><creatorcontrib>Liu Yin, John A</creatorcontrib><creatorcontrib>Lewis, S. Mitchell</creatorcontrib><creatorcontrib>Messinezy, Maria</creatorcontrib><creatorcontrib>Pearson, Thomas C</creatorcontrib><creatorcontrib>Reid, Cecil</creatorcontrib><title>Determination of Serum Immunoreactive Erythropoietin in the Investigation of Erythrocytosis</title><title>The New England journal of medicine</title><addtitle>N Engl J Med</addtitle><description>We assessed the diagnostic value of determinations of serum levels of immunoreactive erythropoietin in 90 patients referred for the investigation of a raised packed red-cell volume (hematocrit) and possible erythrocytosis (a red-cell volume greater than that predicted by weight, body-surface area, or both). The mean values for erythropoietin were 16 mlU per milliliter (range, 8 to 22) in patients with polycythemia rubra vera (n = 24),30-mlU per milliliter (range, 14 to 123) in patients with secondary erythrocytosis (n = 12), 27 mlU per milliliter (range, 13 to &gt;400) in patients with erythrocytosis of unknown origin (n = 19), and 25 mlU per milliliter (range, 18 to 35) in normal controls (n = 25). The values in the patients with polycythemia rubra vera were lower than those in the other three groups (P&lt;0.01, P&lt;0.05, and P&lt;0.0001, respectively). In subjects with an increased packed red-cell volume but without erythrocytosis (n = 35), the levels of serum erythropoietin were the same as those in normal controls. Among patients with erythrocytosis with an unknown cause, abnormally high serum erythropoietin levels were found in 3 of 19 subjects, and in 1 of these 3 the abnormality was intermittent. Thus, measurement of serum erythropoietin in a single sample may be misleading and may not have high discriminatory value in distinguishing between polycythemia rubra vera and secondary erythrocytosis. This assay is useful in identifying patients with secondary erythrocytosis who have inappropriate erythropoietin secretion. (N Engl J Med 1986; 315:283–7.) THE differential diagnosis of erythrocytosis due to an unknown cause, after the exclusion of both polycythemia rubra vera and secondary erythrocytosis attributable to an associated disorder, can be a difficult problem. 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Mary</au><au>Doré, Caroline J</au><au>Liu Yin, John A</au><au>Lewis, S. Mitchell</au><au>Messinezy, Maria</au><au>Pearson, Thomas C</au><au>Reid, Cecil</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Determination of Serum Immunoreactive Erythropoietin in the Investigation of Erythrocytosis</atitle><jtitle>The New England journal of medicine</jtitle><addtitle>N Engl J Med</addtitle><date>1986-07-31</date><risdate>1986</risdate><volume>315</volume><issue>5</issue><spage>283</spage><epage>287</epage><pages>283-287</pages><issn>0028-4793</issn><eissn>1533-4406</eissn><coden>NEJMAG</coden><abstract>We assessed the diagnostic value of determinations of serum levels of immunoreactive erythropoietin in 90 patients referred for the investigation of a raised packed red-cell volume (hematocrit) and possible erythrocytosis (a red-cell volume greater than that predicted by weight, body-surface area, or both). The mean values for erythropoietin were 16 mlU per milliliter (range, 8 to 22) in patients with polycythemia rubra vera (n = 24),30-mlU per milliliter (range, 14 to 123) in patients with secondary erythrocytosis (n = 12), 27 mlU per milliliter (range, 13 to &gt;400) in patients with erythrocytosis of unknown origin (n = 19), and 25 mlU per milliliter (range, 18 to 35) in normal controls (n = 25). The values in the patients with polycythemia rubra vera were lower than those in the other three groups (P&lt;0.01, P&lt;0.05, and P&lt;0.0001, respectively). In subjects with an increased packed red-cell volume but without erythrocytosis (n = 35), the levels of serum erythropoietin were the same as those in normal controls. Among patients with erythrocytosis with an unknown cause, abnormally high serum erythropoietin levels were found in 3 of 19 subjects, and in 1 of these 3 the abnormality was intermittent. Thus, measurement of serum erythropoietin in a single sample may be misleading and may not have high discriminatory value in distinguishing between polycythemia rubra vera and secondary erythrocytosis. This assay is useful in identifying patients with secondary erythrocytosis who have inappropriate erythropoietin secretion. (N Engl J Med 1986; 315:283–7.) THE differential diagnosis of erythrocytosis due to an unknown cause, after the exclusion of both polycythemia rubra vera and secondary erythrocytosis attributable to an associated disorder, can be a difficult problem. Estimates of erythropoietin by bioassays in vivo have an established place in the study of polycythemic states. 1 , 2 However, in vivo bioassays are not practical for large numbers of samples, sthey are expensive, and if the serum has a normal or low concentration of erythropoietin, a substantial sample volume must be concentrated before the assay. 2 In vitro bioassays that use cells in culture vary in specificity; in fact, published estimates . . .</abstract><cop>Boston, MA</cop><pub>Massachusetts Medical Society</pub><pmid>3724821</pmid><doi>10.1056/NEJM198607313150503</doi><tpages>5</tpages></addata></record>
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ispartof The New England journal of medicine, 1986-07, Vol.315 (5), p.283-287
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subjects Adult
Aged
Bioassays
Biological and medical sciences
Cell size
Cloning
Diagnosis, Differential
Diseases of red blood cells
Erythropoietin
Erythropoietin - blood
Female
Hematocrit
Hematologic and hematopoietic diseases
Hematology
Humans
Hypoxia
Male
Medical sciences
Middle Aged
Patients
Plasma
Polycythemia
Polycythemia - diagnosis
Polycythemia - etiology
Polycythemia Vera - diagnosis
Polycythemias
Serum levels
title Determination of Serum Immunoreactive Erythropoietin in the Investigation of Erythrocytosis
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