IIARD International Institute of Academic Research and Development

INTERNATIONAL JOURNAL OF MEDICAL EVALUATION AND PHYSICAL REPORT (IJMEPR )

E-ISSN 2579-0498
P-ISSN 2695-2181
VOL. 9 NO. 1 2025
DOI: 10.56201/ijmepr.v

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Risk Factors Associated With Elevated Red blood Cell Count In Children: A Comprehensive Review

Teeb M. Jaafar Al-khafaji

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Abstract

Elevated red blood cell (RBC) count, also known as erythrocytosis, in children is a rare but clinically significant condition that requires careful evaluation and management. This review explores the risk factors associated with elevated RBC counts in pediatric populations, including physiological responses to environmental conditions, chronic illnesses, genetic predispositions, and hematologic disorders. Understanding these risk factors and their underlying mechanisms is essential for clinicians in diagnosing and managing erythrocytosis effectively. The review also emphasizes distinguishing between primary and secondary causes of erythrocytosis to guide treatment and prevent complications.

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References:

1. Scott O, Black J, Warren T, Green M, Williams S. Erythrocytosis in children with
chronic hypoxia. J Pediatr Hematol Oncol. 2021;43(4):195-201.
2. Williams J, Smith R, Johnson H, O'Brien A. The role of erythropoietin in pediatric
polycythemia. J Pediatr. 2020;158(3):405-409.
3. Thompson L, Thomas G, Reynolds A. Cardiopulmonary abnormalities and
erythrocytosis in children. Pediatr Cardiol. 2019;40(6):1225-1231.
4. Zhang W, Chen H, Wu P, Zhang Y. Chronic hypoxia as a cause of secondary
erythrocytosis in children. Chest. 2018;153(4):883-889.
5. Lee S, Kim T, Oh H, Jung H, Kim J, Choi M. Polycythemia in congenital heart disease:
A retrospective analysis. Heart. 2022;108(6):394-399.
6. Choi H, Park T, Choi Y, Yoo H, Lee W, Kim M. The impact of dehydration on red
blood cell count. Pediatr Emerg Care. 2020;36(6):358-363.
7. Mitchell P, Lewis C, Simon G. Dehydration and erythrocytosis: A clinical perspective.
Arch Dis Child. 2017;102(5):452-457.
8. Harris A, Parker J, Ballantyne C, Fisher G, Johnson D. Polycythemia in children living
at high altitudes: A review. J Pediatr. 2022;161(2):230-236.
9. Foster R, Brown M, Powell C. The effects of living at high altitudes on RBC count in
children. Altitude Med Respir. 2021;35(3):109-114.
10. Tan S, Lee W, Chan K, Goh J, Tan T, Lim L. High altitude and polycythemia in
children: A cross-sectional study. Pediatr Res. 2020;87(3):523-528.
11. Mendoza J, Chan W, Lum H, Lim T. High-altitude polycythemia: Etiology and
management in children. J Clin Pediatr. 2019;58(5):456-460.
12. McKinney K, Johnson L, Wilson S, Andrews R, Williams A. Genetic basis of
erythrocytosis in high-altitude populations. Nat Genet. 2020;52(7):1072-1076.
13. Jones T, Fitzgerald M, Manning D. Polycythemia vera in children: A rare cause of
erythrocytosis. J Pediatr Hematol Oncol. 2018;40(2):e84-e89.
14. Carter B, Rowland L, King R, Marlow D, Patel M. Polycythemia vera in the pediatric
population: A case study. Pediatr Blood Cancer. 2020;67(3):115-118.
15. Pullen J, Hollingsworth J, Adams G, Smith L, Chou T. Hematologic disorders leading
to elevated RBC count in children. Blood. 2017;130(22):2436-2441.
16. Reyes C, Garcia A, Diaz M, Tran M. Genetic mutations associated with familial
erythrocytosis. Blood Cells Mol Dis. 2019;74:85-90.
17. Yu Z, Xu Y, Zhang X, Zhao L, Li Q. The role of the EPOR gene in familial
erythrocytosis. Blood Rev. 2020;34(5):14-19.
18. James M, Wilson R, Patterson J, Walker M. VHL gene mutations in erythrocytosis.
Pediatr Blood Cancer. 2021;68(4):528-532.
19. Davidson L, Patel P, Wu M, Moore H, Rees C. Tumors producing erythropoietin in
children: A clinical review. J Pediatr Hematol Oncol. 2021;43(9):654-659.
20. Keeler L, Thompson J, Jones G, Gray D, Blair J. Renal tumors and erythropoietin
secretion in pediatric patients. J Urol. 2018;199(4):1031-1036.
21. Thomas R, Allen B, Kim S, McBride L, Cameron L. Endocrine tumors and
polycythemia in children. Pediatr Endocrinol Rev. 2020;17(2):132-137.
22. McConnell K, Lee R, Robinson A, Lang M, Reeve S. Neonatal polycythemia: An
overview of causes and management. J Pediatr. 2018;172(3):123-128.
23. Geller T, Stevens R, Marshall E, Dorsey M, Carlson J. Neonatal polycythemia and
intrauterine growth restriction. Neonatology. 2021;119(1):23-29.
24. Wendt E, Alvarado M, Choi J, Hall C, Garcia S. Polycythemia in premature neonates:
Risk factors and clinical significance. Pediatrics. 2019;143(5):324-328.
25. Park K, Robinson C, Lee T, Reynolds R, McKay G. Management strategies for
secondary erythrocytosis in children. Pediatr Hematol Oncol. 2019;38(2):145-151.
26. Turner J, Choi M, Wong G, Davies L. Hematological evaluation of children with
polycythemia. Blood Cells Mol Dis. 2019;68(1):21-26.
27. Spencer R, Howard L, Barnett T, Wong P, Miller J. Role of erythropoietin in secondary
erythrocytosis: Implications for pediatric management. J Clin Pediatr. 2020;38(4):150-
155.
28. Huang M, Liu Y, Zhang F, Zhang Z. Treatment strategies for polycythemia in children.
Pediatr Blood Cancer. 2017;64(8):1119-1124.
29. Daniels L, Patel R, Chow S, Li G, Dorsey M. Polycythemia vera in childhood: Case
series and literature review. Clin Pediatr Hematol Oncol. 2020;17(3):131-135.
30. Phillips D, Garcia M, Horne J, Wilson D. Erythrocytosis in children: A review of 130
cases. Pediatr Hematol Oncol. 2022;43(8):529-535.
31. Arnold D, Miller A, Cole J, Perry M, Griffith T. The impact of blood viscosity on
pediatric erythrocytosis. J Pediatr Hematol Oncol. 2020;42(4):243-248.
32. Brown L, Sutherland E, Porter M, Richards A, Johnson P. Erythrocytosis and increased
risk of stroke in children. Pediatr Neurol. 2019;94:72-77.
33. Grissom L, Ball S, Lacey P, Chang R, Hunt M. Headache and dizziness associated with
polycythemia in children. J Pediatr Neurol. 2020;38(5):370-375.
34. Perez A, Guerrero M, Roque P, Smith J. Blood gas analysis in diagnosing hypoxiainduced erythrocytosis in children. Pediatr Pulmonol. 2020;55(9):2380-2386.
35. Cohen T, Hartmann L, Clark J, Weber L, James S. Genetic screening in pediatric
polycythemia: A review. Pediatr Blood Cancer. 2021;68(5):720-724.
36. Burrows C, Richards J, O'Leary G, Townsend R. Hematological management of
children with secondary erythrocytosis. J Pediatr Hematol Oncol. 2019;41(3):201-206.
37. Zhang Z, Fu Y, Tang R, Zhou S, Li H. Genetic mutations associated with polycythemia
vera in children: A systematic review. Pediatrics. 2020;146(4):e20200113.
38. Kim S, Lee J, Williams D, Baker M, Lee R. Diagnosis and management of hypoxiainduced polycythemia in pediatric patients. J Pediatr. 2021;175(1):103-109.
39. Stewart S, Harris G, Brennan M, Williams T. The role of high-altitude exposure in
pediatric polycythemia. Altitude Med Respir. 2020;33(2):57-62.
40. Peterson P, Walton S, Brown A, Carter S. Strategies for management of dehydrationrelated erythrocytosis in children. J Pediatr Gastroenterol Nutr. 2020;70(2):255-260.
41. Rodriguez B, Meyer S, Wang Z, Huffman G. Dehydration-induced polycythemia in
children: Case studies and management. Pediatr Emerg Care. 2019;35(6):425-429.
42. Lang M, Yuen L, Lawrence D, White D. The role of EPO in erythrocytosis due to
chronic kidney disease. Kidney Int. 2019;95(3):691-699.
43. Ross G, Lee M, Anderson A, Glover M. Management of children with secondary
erythrocytosis due to chronic lung disease. Pediatr Pulmonol. 2021;56(4):1052-1058.
44. Moore J, Williams T, Phillips S, Bennett R, Baker M. The role of early intervention in
managing congenital heart defects leading to erythrocytosis. Heart. 2019;106(6):436-
441.
45. Reeve M, Anderson L, Robinson G, Mitchell D, Kim S. Erythrocytosis in children with
congenital heart disease: Management and outcomes. J Pediatr Cardiol.
2018;39(7):123-128.
46. Liu T, Evans P, Williams C, West L. Effects of polycythemia vera in children and
clinical management. Pediatr Blood Cancer. 2020;67(4):381-386.
47. Goldstein R, Stevens S, Marshall D, Muir J, Clarke T. Long-term outcomes in children
diagnosed with secondary erythrocytosis. Pediatr Hematol Oncol. 2019;36(5):351-356.
48. Chang E, Jones R, Turner S, Lee M, Robertson A. Treatment options for secondary
erythrocytosis in children: A clinical overview. J Pediatr Hematol Oncol.
2020;42(10):753-758.

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