Polycythemia Associated With Obesity

In severe grades of obesity, large deposits of fat cover the viscera and fat infiltrates the parenchyma of vital organs. These morphological changes may be reflected in a wide variety of physiological aberrations. Clinical hypertension, albuminuria, and cylindruria may follow excessive perirenal fat deposition. Liver cells, bulging with fat vacuoles, perform relatively poorly in clinical tests of hepatocellular function. The thoracic cavity may be crowded by fat from within and without, and the vital capacity is accordingly compromised with attendant dyspnea on minimal exertion. In a massively obese patient (case 1) who demonstrated rather marked metabolic aberrations of this type, polycythemia was also found. Of particular interest in this case was the complete disappearance of polycythemia with weight reduction and without any other therapy. The related metabolic disturbances were similarly reversed on low-calorie diet alone. These findings suggested that a form of polycythemia may be related to obesity. In searching