Pediatric Polycythemia Differential Diagnoses

Updated: Jun 13, 2023
  • Author: May C Chien, MD; Chief Editor: Lawrence C Wolfe, MD  more...
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DDx

Diagnostic Considerations

See the list below:

  • Neonatal considerations (hematocrit >65%)
  • Normal intrauterine environment
  • Delayed cord clamping
  • Twin-twin transfusion
  • Maternal-fetal transfusion
  • Maternal smoking
  • Maternal heart disease
  • Maternal preeclampsia/eclampsia
  • Placental insufficiency
  • Maternal propranolol use
  • Intrauterine growth retardation
  • Neonatal thyroid toxicosis
  • Congenital adrenal hyperplasia
  • Trisomy 21, trisomy 13, trisomy 18
  • Hypoxemia
  • Altitude
  • Cardiac disease (right to left shunt)
  • Lung disease (chronic obstructive lung disease, sleep apnea)
  • Central hypoventilation
  • Hemoglobinopathy
  • High–oxygen affinity variety
  • Methemoglobin reductase deficiency
  • Chronic carbon monoxide exposure
  • Erythropoietin-producing tumors
  • Malignant tumor (eg, renal carcinoma, Wilms tumor, hepatomas, adrenal tumors, cerebellar hemangioblastomas)
  • Renal disease (eg, cysts, hydronephrosis, benign renal tumors)
  • Adrenal disease (eg, virilizing hyperplasia, Cushing syndrome)
  • Anabolic steroid use
  • Familial/congenital polycythemia
  • 2,3-Bisphosphoglycerate deficiency
  • Chuvash polycythemia
  • Relative erythrocytosis
  • Secondary to decreased plasma volume as with severe dehydration

Differential Diagnoses