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July 15, 1983

Unnecessary Speculation About Glucose and RBCs

Author Affiliations

Georgetown University School of Medicine Washington, DC

JAMA. 1983;250(3):360. doi:10.1001/jama.1983.03340030022014

To the Editor.—  Because it lacks experimental data that could readily have been obtained, I believe that the article entitled "Artifactual Hypoglycemia Associated With Polycythemia Vera" (1983;249:774) by Billington et al was published prematurely.The authors speculated that increases in RBC glycolytic enzymes might explain the hypoglycemia that they noted when whole-blood samples from polycythemic persons were incubated for several hours. Unfortunately, they did not include information on their patients' reticulocytes, although it has been stated that those young cells carry on more active glycolysis than do mature erythrocytes.1 Thus, an elevated reticulocyte count reflecting hyperactive erythropoiesis might largely explain their observations. This would be particularly so if, as they contend, the other formed elements, whose levels were increased in most of their five cases of polycythemia vera, were not responsible.It would be possible to compare glycolytic activity of RBCs from polycythemic and normal persons after washing the