What is the role of polycythemia vera in the pathogenesis of hematologic pruritus?

Updated: Mar 03, 2020
  • Author: David F Butler, MD; Chief Editor: William D James, MD  more...
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Answer

Patients with polycythemia vera have increased numbers of circulating basophils and skin mast cells, which have been correlated with itching. The itch typically occurs during cooling after a hot shower. Mast cell prostaglandins and increased platelet degranulation, which lead to the release of serotonin and prostanoids, are thought to be important mediators of itching, along with iron deficiency, which may be a contributing factor. The fact that aspirin and paroxetine alleviate this form of pruritus suggests that serotonin from platelets may play a role. However, one study showed that the concentration of platelet serotonin was the same in polycythemic patients with and without pruritus. [16]


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