Polycythemia occurs in up to 5% of neonates. Neonates with polycythemia develop a hyperviscosity syndrome that may vary in severity. The infant may appear asymptomatic or symptoms may be ascribed to another cause.


Clinical findings:

(1) plethora and/or cyanosis

(2) lethargy and sleepiness

(3) vomiting

(4) poor feeding and/or poor sucking

(5) tachypnea

(6) tachycardia

(7) tremors, jitteriness or irritability

(8) hypotonia

(9) oliguria

(10) cardiomegaly

(11) rarely seizures

(12) occasionally necrotizing enterocolitis


Hemoglobin and hematocrit should be measured if the diagnosis is suspected. A hematocrit > 65% (which corresponds to a hemoglobin > 22 g/dL) indicates the presence of polycythemia.


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