GULHANE MEDICAL JOURNAL 2019 , Vol 61 , Issue 2
Do we care enough about the role of smoking in the etiology of polycythemia?
Ramazan Öcal1,Yakup Arslan2,Gökhan Özgür1,Deniz Doğan2,Murat Yıldırım1,Nesrin Öcal2
1University of Health Sciences, Gulhane Faculty of Medicine, Hematology, Ankara, Turkey
2University of Health Sciences, Gulhane Faculty of Medicine, Chest Diseases, Ankara, Turkey
DOI : 10.26657/gulhane.00053 Aims: Smoking is associated with both primary and secondary polycythemia. In this study, we aimed to determine the role of smoking on polycythemia etiology in patients without active pulmonary pathology.

Methods: Data of the patients with polycythemia detected in Hematology clinic and referred to the Chest Diseases department for investigation of possible secondary polycythemia etiologies during the last one year were reviewed retrospectively.

Results: 82 patients had been referred to Chest Diseases. In 15 patients lung diseases were found to cause secondary polycythemia. Smoking was detected in 48 patients (58.53% of all cases and 71.64% of those without pulmonary pathology). The mean hemoglobin (HGB), hematocrit (HCT), red blood cell (RBC), red cell distribution width (RDW), mean corpuscular volume (MCV) values were significantly higher in smokers (p=0.01, p=0.01, p=0.01, p=0.04 and p=0.03, respectively). Smokers had significantly higher mean carboxyhemoglobin (COHgb) ratio (p=001). In 89.58% of smokers, COHgb was found to be high. 10.42% of all smokers were found to have no COHgb elevation. There were significantly positive correlations between the COHgb ratios with the cigarette quantity (package/year), HGB, HCT, RBC, RDW and MCV values. Isolated smoking was accepted as the presumably cause of secondary polycythemia in 58.53% of all cases.

Conclusions: Smoking history should be questioned in the etiological assessment of polycythemia. While COHgb measurement may prevent many unnecessary investigations, it should be borne in mind that COHgb is not the only factor in the effect of smoking on erythropoiesis. Keywords : Polycythemia, smoking, hematocrit, tobacco, carbon monoxide