Blog - INTERNET MÉDICA

Policitemia Vera (Polycythemia Vera)

Por Paulo Leite 05/11/2021

– A policitemia vera (PV) é uma doença mieloproliferativa crônica, caracterizada pela proliferação de precursores hematopoéticos, principalmente da série eritróide. Ela se caracteriza por medula óssea hipercelular. É o mais comum dos distúrbios mieloproliferativos, com uma incidência de aproximadamente 2/100000 pessoas. O diagnóstico de PV torna necessária a exclusão de causas secundárias. A flebotomia é o tratamento primário para a PV. A hidroxiuréia, interferon e anagrelídeo para citorredução ficam reservados para os pacientes com trombocitose persistente ou que correm um maior risco de eventos tromboembólicos. Os portadores de PV em vários centros hematológicos apresentaram longa sobrevida. Os eventos trombóticos arteriais foram a principal complicação em portadores de policitemia vera.

– A eritrocitose secundária é um aumento da massa de glóbulos vermelhos causada por um estímulo à produção dessas células, podendo ocorrer por um processo de hipoxemia crônica. Em nosso meio, as causas mais frequentes de eritrocitose secundária a hipoxemia são as cardiopatias cianogênicas e a doença pulmonar obstrutiva crônica. Essas condições resultam em uma menor oxigenação tecidual, o que estimula uma maior produção de eritropoietina pelos rins, através do fator de transcrição induzível pela hipóxia. A eritrocitose ocorre para um melhor fornecimento de oxigênio aos tecidos, mas acaba por causar hiperviscosidade sanguínea, que por sua vez leva a diversos sintomas e a um maior risco trombótico.

■ Polycythemia vera: update on emerging treatment options

Giulia Benevolo, Francesco Vassallo, Irene Urbino, Valentina Giai

Ther Clin Risk Manag.2021; vol 17: 209–221

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7981161/

■ Advances in the treatment of polycythemia vera: trends in disease management

Yajur Arya, Arshi Syal, Monica Gupta, Saurabh Gaba

Cureus.2021, vol 13(3): e14193.

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC8084584/

■ Emerging agents and regimens for polycythemia vera and essential thrombocythemia

Rory M. Shallis, Nikolai A. Podoltsev

Biomark Res.2021; vol 9: 40

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC8161993/

■ Lemierre´s syndrome in an elderly female patient wity polycythemia vera: Does polycythemia predispose to Lemierre´s syndrome?

Sanchit V. Kundal, Jasmine Lee, Mazin Khalid et al

Am J Case Rep.2021; vol 22: e933587-1–e933587-5

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC8488186/

■ Transformation of polycythemia vera to pure erythroid leukemia

Louisa Liu, Neil Dudheker, Lhara M Sumarriva Lezama et al

Cureus.2021, vol 13(7): e16168

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC8330807/

■ Ginostat: an emerging treatment for polycythemia vera

Helen T. Chifotides, Prithviraj Bose, Srdan Verstovsek

Expert Opin Investig Drugs. 2020 Jun; 29(6): 525–536

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7534842/

■ Recents advances in prognostication and treatment of polycythemia vera

B K Marcelino, R Hoffaman

Fac Rev 2021, vol 10: 29

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC8009192/

■ Interferon alpha therapy in essential thrombocythemia and polycythemia vera – a systematic review and meta-analysis

Jan Philipp Bewersdorf, Smith Giri, Rong Wang et al

Leukemia.2021, vol 35(6): 1643–1660

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7917159/

■ Investigation and management of erythrocytosis

S Mithoowani, M Laureano, M A Crowther, C M Hillis

CMAJ 2020, vol192 (32) E913-E918

https://www.cmaj.ca/content/192/32/E913

■ Ruxotilinib for the prevention of thrombosis in polycythemia vera: a systematic review and meta-analysis

Arianna Masciulli, Alberto Ferrari, Alessandra Carobbio, Arianna Ghirardi, Tiziano Barbui

Blood Adv.2020, vol 4(2): 380–386

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC6988397/

■ Is there a gender effect in polycythemia vera?

Francesca Palandri, Barbara Mora, Naseema Gangat, Lucia Catani

Ann Hematol.2021, vol 100(1): 11–2

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7782364/

■ Recent advances in the use of molecular analyses to inform the diagnosis and prognosis of patients with polycythaemia vera

Ruth Stuckey, María Teresa Gómez-Casares

Int J Mol Sci.2021, vol 22(9): 5042

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC8126083/

■ Evaluation of therapeutic strategies to reduce the number of thrombotic events in patients with polycythemia vera and essential thrombocythemia

Douglas Tremblay, Heidi E. Kosiorek, Amylou C. Dueck, Ronald Hoffman

Front Oncol.2020; vol 10: 636675

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7921696/

■ Avaliação e tratamento da eritrocitose secundária a hipóxia crônica

S T F Grunewald

Rev Med Minas Gerais 2019, vol 29: e-2026

http://www.rmmg.org/artigo/detalhes/2588

■ Non-enhanced CT mimicking contrast enhanced CT – a case report on polycythemia

Pooja Varwatte, Gurubharath Ilangovan, Harshavardhan Balganeshan et al

J Radiol Case Rep.2019, vol 13(4): 10–16

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC6743642/

■ Update in the management of polcythemia vera and essential thrombocythemia

Prithviraj Bose, Srdan Verstovsek

Ther Adv Hematol.2019; vol 10: 2040620719870052

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC6719465/

■ Dr Paulo Fernando Leite

Cardiologia/Prevenção Cardiovascular

Consultório: Rua Padre Rolim 815/sala 601 – Belo Horizonte/MG/Brasil

Tel: 33245518

CRMMG: 7026

Email: pfleite1873@gmail.com

Blog Internet Médica – www.internetmedica.com.br

Data: novembro 2021

COVID-19, Exercício & Esporte (COVID-19, Exercise & Sports)

Por Paulo Leite 30/10/2021

■ Posicionamento sobre avaliação pré-participação cardiológica após a COVID-19: Orientações para retorno à prática de exercícios físicos e

C S S S Colombo, N Ghorayeb

Arq Bras Cardiol 2021, vol 116 (6)

https://www.scielo.br/j/abc/a/CKBVQbdHV7gzVVKT8TVJf7D/?lang=pt (Portuguese)

https://www.scielo.br/j/abc/a/CKBVQbdHV7gzVVKT8TVJf7D/?lang=en (English)

■ Comparação entre três protocolos para o retorno ao esporte durante a pandemia de COVID-19

J E N Moura, I A F Feitosa, G M C Nogueira et al

Revista Medicina 2021, vol 100 (3)

https://www.revistas.usp.br/revistadc/article/view/176019

■ Prevalence of clinical and subclinical myocarditis in competitive athletes with recent SARS-CoV-2 infection: results from the big ten COVID-19 Cardiac Registry

Curt J. Daniels, Saurabh Rajpal, Joel T. Greenshields et al

JAMA Cardiol.2021, vol 6(9): 1078–1087

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC8160916/

■ Screening of potential cardiac involvement in competitive athletes recovering from COVID-19: an expert consensus statement

Dermot Phelan, Jonathan H. Kim, Michael D. Elliott et al

JACC Cardiovasc Imaging.2020, vol 13(12): 2635–2652

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7598679/

■ Cardiorespiratory considerations for return-to-play in elite athletes after COVID-19 infection: a practical guide for sport and exercise medicine physicians

Mathew G Wilson, James H Hull, John Rogers et al

Br J Sports Med.2020, vol 54(19): 1157–1161

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7513247/

■ COVID-19 and surging: problems, strategies and solutions for suffers

G H V Lima, P L G, M Baboghluian

Rev Bras Med Esporte 2021, vol 27 (1)

https://www.scielo.br/j/rbme/a/H4PP8BqWBJVbySt4KbssJRm/?lang=en

■ Perceptive changes in endurance athletes during social isolation due to COVID-19

Rev Bras Med Esporte 2020, vol 26 (2)

https://www.scielo.br/j/rbme/a/njpbHr336kHRFCjKZvpz5vy/?lang=en

■ Returning to play after prolonged training restrictions in professional collision sports

Keith A. Stokes, Ben Jones, Mark Bennett et al

Int J Sports Med.2020, vol 41(13): 895–911

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7799169/

■ The injury rate in National Football League players increasdd following cancellation of preseason games because of COVID-19

H P Baker, S Pirkle, M Cahill et al

Arthrosc Sports Med Rehabil 2021, vol 3 (4): e1147-e1154

https://www.arthroscopysportsmedicineandrehabilitation.org/article/S2666-061X(21)00080-8/fulltext

■ The Australian Institute of Sport framework for rebooting sport in a COVID-19 environment

David Hughes, Richard Saw, Nirmala Kanthi Panagodage Perera et al

J Sci Med Sport.2020, vol 23(7): 639–663

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7200343/

■ Exercise in the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2 era: A question and answer session with the experts endorsed by the section of Sports Cardiology & Exercise of the European Association of Preventive Cardiology (EAPC)

Raghav T Bhatia, Sarandeep Marwaha, Aneil Malht al

Eur J Prev Cardiol.2020, vol 27(12): 1242–1251

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7717284/

■ A prospective study on the consequences of SARS-CoV-2 infection on the heart of young adult competitive athletes: implications for a safe return-to-play

Luna Cavigli, Federica Frascaro, Francesca Turchini et al

Int J Cardiol.2021, vol 336: 130–136

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC8166156/

■ The benefits of vitamin D supplementation for athletes: better performance and reduced risk of COVID-19

William B. Grant, Henry Lahore, Michelle S. Rockwell

Nutrients.2020, vol 12(12): 3741

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7761895/

■ Dual careers of athletes during COVID-19 lockdow

Pascal Izzicupo, Angela Di Baldassarre, Ilvis Abelkalns et al

Front Psychol.2021; vol 12: 657671.

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC8047065/

■ Training during the COVID-19 lockdown: knowledge, beliefs, and practices of 12,526 athletes from 142 countries and six continents