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Polycythemia vera: Suspect-and-test checklist for clinicians

A one-page worksheet that turns the full Polycythemia vera diagnosis guide into something you can use at the point of care: what to look for, what to order, which results should not end the workup, and who else to test or refer.

Who it is forClinicians and care teams who may see Polycythemia vera before it is diagnosed, including primary care, the specialists named in the guide, and referral or genetics coordinators.
When to use itWhen Polycythemia vera is on the differential, when a patient has several red flags, or when you are preparing a referral or a second opinion.

How to use it, section by section

  1. Red flags present: Tick each finding the patient has. They are grouped by body system so you can scan quickly.
  2. Already labeled as: Tick earlier diagnoses on the chart that the sources say are often given first.
  3. Family to test: Note relatives who may need testing, and record when symptoms began and which specialists have already been seen.
  4. Testing, in order: Tick each test as you order it and write the result on its line. The order follows the published sources.
  5. Results that do not rule it out: A reminder of findings that can look reassuring but do not exclude Polycythemia vera.
  6. Specialists: Tick the referral, then write who it went to and any notes.
Two ways to fill it inPrint it blank and write on it, or tick boxes and type on this screen first, then print or save as a PDF. Keep it with the chart or send it with the referral.
PrivacyNothing you type is sent or saved. It stays in this browser tab and disappears when you close it. Use patient initials, not full identifiers.

What it is not: Not a diagnostic score, a protocol or coding advice. It summarizes published sources, and clinical judgment and the treating clinician govern. Every point is sourced in the full Polycythemia vera guide.

One Letter page. Use your browser's print or save as PDF.Full guide with sources
Suspect-and-test checklist
Polycythemia vera

JAK2-mutated blood cancer. Start from a sustained high hemoglobin or hematocrit, an unusual clot or itch after water.

ICD-10-CMD45Trial Friend for Clinicians

1Red flags present

Blood count

Itch, hands, feet and vision

Clots

Examination and history

2Already labeled as

3Family to test

4Testing, in the order the sources describe

  1. Repeat blood count and review earlier countsSeparates longstanding from acquired erythrocytosis; sustained is typically 3 months or longer.
    Result
  2. History for secondary causesSmoking, heart and lung disease, sleep apnea, altitude, tumors, androgens, SGLT2 inhibitors.
    Result
  3. JAK2 V617F on peripheral bloodFirst step per Mayo Clinic and Italian authors. ICC advises assays with sensitivity under 1%.
    Result
  4. Serum erythropoietinSubnormal level is the minor criterion. Normal in 17% of patients with PV.
    Result
  5. JAK2 exon 12 (exons 12 to 15)If V617F is negative and PV is still suspected; other JAK2 mutations make up about 3%.
    Result
  6. WHO or ICC criteriaAll 3 major, or the first 2 major plus subnormal erythropoietin.
    Result
  7. Bone marrow biopsyMajor criterion. May be omitted above 18.5g/dL (men) or 16.5g/dL (women) with JAK2; WHO 2016 also asks for low erythropoietin.
    Result
  8. JAK2 V617F after a splanchnic clotBaveno VII: all adults with primary splanchnic vein thrombosis.
    Result
  9. Oximetry, p50 and hereditary panelFor JAK2-negative erythrocytosis with no cause found.
    Result

5Results the sources say do not rule it out

  • Negative JAK2 V617F. Other JAK2 mutations, including exon 12, account for about 3%.
  • Normal erythropoietin. Subnormal in 81%, normal in 17%.
  • Hemoglobin below the threshold with iron deficiency, a large spleen or a rise from baseline.
  • A sleep apnea, smoking or testosterone label. Sources still put JAK2 screening first.
  • Another clot risk factor or an evident stroke cause.
  • Positive JAK2 V617F alone. Also found in ET, myelofibrosis and 3.1% of one general population.

6Specialists the sources name

Diagnosis code: D45 Polycythemia veraCodes patients often carry before diagnosis are listed in the online guide.
Full guide and sourcesEvery point here is sourced in the online guide, which also has a patient note to print.
Trial Friend, trialfriend.com/for-clinicians. Key sources: ICC 2022 criteria (Gianelli 2023); WHO 5th edition (Khoury 2022); WHO 2016 criteria summary (Barbui 2018); JAMA review 2025; International PV study (Tefferi 2013); Tefferi, Vannucchi and Barbui 2021; all 39 with links in the online guide. Checked November 12, 2026. A reference checklist for licensed clinicians that summarizes published sources. It is not a diagnostic tool, a score or a protocol, and it does not replace clinical judgment, local practice or the prescribing information. Not coding advice. Trial Friend never receives anything written or typed on this sheet.