Postural hypoxemia and erythrocytosis

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      Seven patients with unexplained erythrocytosis, moderate obesity, and mild hypertension without splenomegaly (Gaisböck's syndrome) were studied. Routine pulmonary studies were normal, but significant arterial hypoxemia was demonstrated in the supine position in all patients. An increase in the serum level of erythropoietin in the supine position was found in five of six patients. Nocturnal oxygen therapy controlled the erythrocytosis in one patient and weight reduction was effective in controlling the hematocrit in another. We were unable to confirm the existence of “Gaisböck's syndrome.” The importance of a complete pulmonary evaluation, including arterial blood gas analysis in the supine position, in all patients with an unexplained erythrocytosis is emphasized. The finding of significant hypoxemia in the supine position in all patients in this study suggests that postural hypoxemia may be a frequent cause of an elevated red cell volume.
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