23 yrs old medico friend went for casual blood checkup as his weight was increased during lockdown and it was associated with symptoms like palpitations...increase in blood pressure...and SOB nyha- Class 2 ..echo and ecg came out to be normal except sinus tachycardia..which subsided later on changing lifestyle...the thing which he is concerned about is he noticed increase in haemoglobin upto 17.9g,RBC count of 6.1 lakhs..one percent increase of HCT compared to normal, overall wbc was normal With slight increase in absolute count of lymphocytes and basophills....after 2-3 days he went for another blood checkup from another lab suspecting polycythemia vera in which it showed haem-16.5g, one percent increase of HCT.. with NORMAL lymphocytes and basophills.. While taking history he said that the reason for NORMAL lympho and baso was becoz he had an abscess since 2 weeks on medial thigh when he went for 1 st blood checkup...and abscess got drain when he went for 2 nd blood checkup.. He later went for serum Erythropoietein which came to be normal (i.e 14 niu/ml)...Looking onto different values from different labs after a week went for another lab where hb showed 16.5g ..rbc count of 6.7 lakhs and slight one percent increase in HCT and rest other values were normal... Now what should we suspect for 16.5 g of haem and rbc of 6.7 lakhs with no symptoms and no other abnormal values.. Reports attached below for reference from 3 different labs numbering 1..2..3 along with normal serum Erythropoietein levels..how to proceed further in this case??

2 Likes

LikeAnswersShare

Polycythemia vera .. Unfortunate to have s this is a type of blood cancer. It causes your bone marrow to make too many red blood cells. These excess cells thicken your blood, slowing its flow, which may cause serious problems, such as blood clots. Consult Hematologist at an earliest.

PCV usually has low EPO level
0

Please rule out secondary causes of raised hemoglobin Example COPD right to left Shunt in great People living at high altitude Chronic smoker Exposed to carbon monoxide in automobile industry Morbid obesity causing Pickwickian syndrome After ruling out secondary causes please do bone marrow examination for confirmation

Thank you doctor
0

Smoker, obese patient, any supplement use??? Are symptoms suggestive of sleep apnea? If you are extremely worried send the JAK2 mutation from peripheral blood. As I have mentioned before, secondary polycythemia is much more common than primary polycythemia (also called polycythemia vera). Rule out secondary causes first. Usually with PCV EPO levels are low/low-normal.

Thank you doctor
0

View 1 other reply

He is a c/o polycythemia vera and need to be under observation of hematologist

Thanx dr Pushkar ji Bhomia
0

View 2 other replies

Polycythemia vera Further evaluation is required for diagnosis and treatment

Thank you doctor
0

She had tachycardia during lockdown period.May be due to anxiety.she might be dehydrated as well causing high haemoglobin.Ensure sufficient oral hydration and repeat CBC

Valuable opinion
0

View 1 other reply

Adv bone marrow biopsy. And Jak2 test.

Thank you doctor
0

Polycythemia vera Adv: further evaluate with BMA

Thank you doctor
0

Polycythemia

Seems to be polycythemia.Pt must b under observation of haematologist.

Load more answers

Cases that would interest you