What hematologic abnormality is likely to be seen in a patient with severe chronic obstructive pulmonary disease (COPD) and resting hypoxia?

In a patient with severe chronic obstructive pulmonary disease (COPD) and resting hypoxia, polycythemia is the likely hematologic abnormality observed. Chronic hypoxia stimulates the kidneys to produce more erythropoietin, a hormone that promotes the production of red blood cells in the bone marrow. This response is the body's mechanism to increase oxygen-carrying capacity under conditions of low oxygen availability.

In the case of severe COPD, the persistent low oxygen levels result in a compensatory increase in red blood cell mass, leading to polycythemia. This condition may enhance fatigue or increase the risk of thrombotic events if it becomes pronounced.

Other hematologic abnormalities listed, such as eosinophilia, lymphocytosis, and thrombocytopenia, do not typically correlate with the chronic hypoxic state induced by COPD. Eosinophilia can be associated with allergic conditions or parasitic infections, lymphocytosis may indicate viral infections or certain chronic inflammatory conditions, and thrombocytopenia is primarily associated with conditions that lead to decreased production or destruction of platelets. None of these conditions relate directly to the body's response to chronic hypoxia in the context of COPD.