Relative polycythemia in acute pancreatitis: a series of case report

Abstract

Polycythemia is an unusual manifestation of acute pancreatitis. When polycythemia does occur, it is almost invariably due to intravascular fluid depletion, contraction of Plasma volume, Gaisbock’s Syndrome, Primary congenital and familial polycythemia, polycythemia vera, Hypoxia as in high altitude, pulmonary cyanotic congenital heart diseases, hypoventilation syndromes like sleep apnea, Smoker’s Polycythemia, carbonmonoxide intoxication caused by industrial exposure, Erythropoietin secreting tumors, post renal transplantation erythrocytosis and congenital polycythemias. This case series report presents four patients with acute pancreatitis and relative polycythemia due to reduction in plasma volume as a result of intravascular volume depletion, as demonstrated by Haemoglobin and Hematocrit during acute pancreatitis and the significance of this association is discussed. Among the case series, the case 1 was relative polycythemia with acute pancreatitis presented as pseudocyst, whereas the case 2, 3 and 4 presented as relative polycythemia with necrotizing pancreatitis. The clinical course of the patient suggested that the relative polycythemia developed subsequent to the clinical onset of acute pancreatitis. It is believed that this represents the first recorded case series in the English Literature of acute pancreatitis with Relative Polycythemia due to reduction in plasma volume as a result of intravascular volume depletion. Four Patients presented with Relative polycythemia during acute pancreatitis was found.