Most abnormal hemoglobins, like hemoglobin S in sickle cell disease, cause problems because they have a reduced ability to carry oxygen or form unstable proteins. However, some rare mutations have the opposite effect: they create a hemoglobin molecule with an abnormally high affinity for oxygen. This means the hemoglobin holds onto oxygen too tightly and does not release it easily to the body's tissues. The kidneys sense this tissue hypoxia (even though oxygen levels in the blood might be normal) and respond by producing more erythropoietin (EPO). The high EPO level drives the bone marrow to make excessive numbers of red blood cells, leading to a condition called familial erythrocytosis or secondary polycythemia. This is in contrast to Polycythemia Vera, which is a primary bone marrow disorder with low EPO levels.

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Zambia

• ivwananji siwale – 29 pts

• Visual Pathway Lesions
• Positive and Negative Symptoms
• Hallucinations and Delusions
• Antipsychotic Medications
• Emergency: Environmental Emergencies