Clinical and physiological aspects of a case of obesity, polycythemia and alveolar hypoventilation.

The occurrence of arterial hypoxia with polycythemia usually results from some known type of pulmonary disease or from an abnormal communication between the right and left sides of the circulation. Although arterial oxygen unsaturation has been observed in patients with polycythemia vera (1-4), it is usually of only mild degree. Recently, Newman, Feltman, and Devlin (5) found polycythemia and a severe degree of arterial hypoxia in two patients who did not have evidence of any previously described form of lung disease. These authors postulated that polycythemia vera by its effects on the lung or on the respiratory center could give rise to oxygen unsaturation of arterial blood. They also suggested that in some patients polycythemia is secondary to respiratory center disease of undetermined etiology. It is the purpose of the present report to present the clinical and physiological findings in an obese young man with polycythemia and arterial oxygen unsaturation.