Patient's Query
Hi doctor,
I am a 34-year-old female. I have been itching all over for months and constantly covered with bruises, petechiae, and livedo reticularis. I was diagnosed with erythromelalgia. I also have severe bone pain. My blood work came back with elevated RBC, Hb, Hct, low alkaline phosphate, low BUN, and creatinine. My vitamin B12 levels are in the 1000s and not under 200. The neurologist says that I have fibromyalgia and changed my seizure medicines for juvenile myoclonic epilepsy. Do I think that I should visit a hematologist and figure out why my bones hurt so badly in my legs and why I am so itchy? My current medication includes Oxycodone and Lamotrigine for epilepsy.
Hi,
Welcome to icliniq.com.
Based on your query, my opinion is as follows:
The elevated hemoglobin, red blood cell count, and hematocrit signify polycythemia. Elevated vitamin B12 level is one of the markers of myeloproliferative disorder. I would strongly think of polycythemia vera.
Other values are within the normal range (attachment removed to protect patient identity) suggesting no renal or liver disorders.
Increased hematocrit will slow down blood flow due to increased viscosity and this can cause few RBCs to move out and lead to these symptoms. Even migraine, bone pain, and increased itching can be attributed to sluggish blood flow.
Polycythemia vera is a cancerous condition and requires evaluation. I would strongly urge you to meet a hematologist.
I hope there are no other causes of polycythemia like lung disorders or staying in hilly regions, etc.
With high vitamin B12 and polycythemia, polycythemia vera needs to be seriously evaluated.
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Answered byDr. Prakash. H. M.
Medically reviewed byiCliniq medical review team
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