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Elevated haemoglobin and haematocrit levels can reflect decreased plasma volume (due to dehydration, alcohol, smoking, diuretics) or increased red cell mass (polycythaemia).
Polycythaemia may be secondary (usually to chronic hypoxia from chronic lung disease, but occasionally to erythropoietin-secreting tumours, especially renal tumours, fibroids) or primary (polycythaemia vera).
Primary polycythaemia or polycythaemia vera (PV):
Consider history:
Evidence of thrombosis or vascular event and raised haematocrit greater than 0.52 (males) or greater than 0.48 (females) warrants acute medical admission
If raised haematocrit greater than 0.52 (males) or greater than 0.48 (females) and evidence of:
Urgent or written haematology advice is available
e-Referral Service Selection
This guideline has been signed off on behalf of NHS Devon.
Publication Date: July 2016