A variety of conditions can lead to secondary polycythemia. Chronic obstructive pulmonary disease (COPD) and sleep apnea can cause overproduction of red blood cells due to the tissues receiving insufficient oxygen. Lung disease, Pickwickian syndrome, and obesity may also lead to the disease. Other causes of secondary polycythemia include carbon monoxide poisoning, performance-enhancing drugs, living at high altitudes, diuretics, and kidney cysts or disease. Parathyroid tumors, benign fibroids, adrenal gland tumors, certain brain tumors, kidney cancer, and liver cancer can also result in too much EPO.

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