POLYCYTHEMIA AND HYDRONEPHROSIS OR RENAL TUMORS

Abstract

Review of the previous literature concerning the simultaneous occurrence of polycythemia and hypernephroma yielded reports of 25 cases of polycythemia and hypernephroma, 1 case of polycythemia and benign renal adenoma and 4 cases of polycythemia and polycystic kidney. In this paper, the authors report a new syndrome, i.e., polycythemia associated with unilateral hydronephrosis, in 1 case caused by a congenital lesion, and 1 associated with a fibromyxoma of the kidney. In these patients the blood values returned to normal following nephrectomy and remained normal for a significant period of time. Also, 2 new cases of polycythemia and hypernephroma are reported and 1 previously reported case is presented in more detail. Blood volume studies using P32-labeled red cells in 2 cases of polycythemia and hypernephroma showed a true and marked increase in total red cell volume and normal or low plasma volume consistent with findings in polycythemia vera and secondary polycythemia and contrasting with the polycythemia of stress. Review of reports of recent experimental work indicates that there is a humoral erythropoietic factor, possibly produced by or related in some way to the kidney. The occurrence of polycythemia with renal lesions and particularly the maintained correction of the polycythemia following nephrectomy in several cases appears to give clinical support to the assumption that the kidney may be a possible source of, or capable of activating such an erythropoietic factor. The method by which this operates is not clear.