Criteria for diagnosis:
(1) presence of polycythemia (elevation in RBC and hemoglobin not due to dehydration)
(2) exclusion of polycythemia from other cause (secondary response to hypoxemia, secondary to increased androgen release, secondary to erythropoietin therapy, associated with polycythemia rubra vera)
(3) reversal on removal of the tumor and recurrence on relapse
(4) presence of an elevated serum erythropoietin level
Tumors that may be associated with polycythemia
(1) renal cell carcinoma (hypernephroma)
(2) uterine leiomyoma (fibromyoma)
(3) cerebellar hemangioblastoma
(4) hepatocellular carcinoma
(5) gastric carcinoma
(6) meningioma
(7) carcinoid tumors
(8) Wilm's tumor
(9) benign renal tumors
Problems in diagnosis:
(1) concurrent blood loss may reduce the red blood cell count to the normal range
(2) an erythropoietin-like substance may not be detected by the antibodies used in an immunoassay
