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Introduction: Although polycythemia vera is rarely seen, absolute polycythemia is seen more frequently and can drastically change imagine interpretation when taken out of context of the patient's chief complaint. Case Report: We report the case of a 21-year-old male without any known medical history who presented as a trauma patient initially diagnosed with acute subarachnoid and subdural hemorrhages. Further examination of the imaging and later serum laboratory findings demonstrated a primary diagnosis of absolute polycythemia, which was an incidental diagnosis that resulted in the patient's care team and disposition being changed. Conclusion: Absolute polycythemia is not uncommon, and its causes vary from congenital and myeloproliferative disorders to chronic obstructive pulmonary disease and sleep apnea. It can cause pseudoenhancement in noncontrast computed tomography (CT) scans because of the increased protein level in the blood, and emergency physicians should consider all differential diagnoses of pseudoenhancement. [ABSTRACT FROM AUTHOR]

Hydroxycarbamide therapy has been associated with significant oscillations in peripheral blood counts from myeloid, lymphoid and erythroid lineages in patients with polycythaemia vera and chronic myeloid leukaemia. We retrospectively evaluated serial blood counts over an 8-year period from 44 adult patients with sickle cell disease receiving hydroxycarbamide. Platelet counts, leucocyte counts, haemoglobin values and reticulocyte counts, apportioned by hydroxycarbamide status, were analysed using a Lomb-Scargle periodogram algorithm. Significant periodicities were present in one or more counts in 38 patients receiving hydroxycarbamide for a mean duration of 4·81 years. Platelet and leucocyte counts oscillated in 56·8% and 52·3% of patients, respectively. These oscillations generally became detectable within days of initiating therapy. During hydroxycarbamide therapy, the predominant periods of oscillation were 27 ± 1 d for platelet counts and 15 ± 1 d for leucocyte counts. Despite an absolute decrease in leucocyte and platelet counts during hydroxycarbamide treatment, the amplitudes between nadirs and zeniths remained similar regardless of exposure. Our observations appear consistent with previously proposed models of cyclic haematopoiesis, and document that hydroxycarbamide-induced oscillations in blood counts are innocuous phenomena not limited to myeloproliferative disorders as described previously. We speculate the known cell cycle inhibitory properties of hydroxycarbamide may accentuate otherwise latent constitutive oscillatory haematopoiesis. [ABSTRACT FROM AUTHOR]