Lots of things: At age 18, polycythemia vera would be surprising. I am more concerned that you may have a right-to-left heart shunt, a high-affinity hemoglobin, or any of a host of other causes of secondary polycythemia. Today the diagnosis of p vera might be made on genetic analysis & finding low erythropoietin, which could be done without a 2 year delay. Consider a 2nd opinion.
Answered 12/9/2013
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