Polycythemia in chronic obstructive pulmonary disease in Minia Cardiothoracic University Hospital

Abstract

Background Secondary polycythemia is linked to cigarette smoking and chronic obstructive pulmonary disease (COPD). However, the prevalence of polycythemia and its possible risk factors in patients with COPD have not been widely studied. In the past, it was known that patients with COPD had a high prevalence of polycythemia.However, owing to the advances in the management of patients with COPD and the use of long-term oxygen therapy to correct hypoxemia in patients with advanced COPD, its frequency is decreasing. Aim The current research was done to evaluate the frequency of polycythemia and its effects in patients with COPD in Minia Cardiothoracic University Hospital. Patients and methods A total of 100 patients with COPD were included within the study. They were assessed for complete demographic and clinical data. Spirometry and arterial blood gases were evaluated. Complete blood count, serum iron, total iron-binding capacity, and erythropoietin level were measured.Patients were divided into two groups: group I, nonpolycythemic patients (86 patients), and group II, polycythemic patients (14 patients). Results Polycythemia was present in 14 (14%) patients. Polycythemic patients had a higher modified Medical Research Council dyspnea grade (P=0.001) and a higher number of exacerbations per year (0.02). There was also a significant increase in serum iron level (170.9 ± 9.6 µg/dl) and total iron-binding capacity (377.1 ± 14.8 µg/dl) with lower erythropoietin (24.04 ± 3.8 mU/ml) in group II compared with group I (134.4 ± 27.4 µg/dl, 310.9 ± 40.1 µg/dl, and 41.9 ± 10.3 mU/ml, respectively) (P=0.001, 0.001, and 0.001, respectively). Conclusion Polycythemia was present in 14% of the studied patients. It was associated with a significantly higher grade of dyspnea and an increased number of exacerbations.