When absolute polycythemia is diagnosed, it should be classified according to possible causes. Specific criteria for the diagnosis of primary polycythemia are established. Secondary polycythemia is differentiated according to whether erythropoietin release is an appropriate response to cellular hypoxia or an inappropriate response to tumors or other abnormalities. Erythropoietin plays an important role in polycythemia. Levels in plasma or urine are characteristically low in primary polycythemia and elevated in secondary polycythemia.
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