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  • CBC numbers

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    Old 05-16-2008, 07:17 PM   #1
    cdavis1980
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    CBC numbers

    Hi, I recenty had a CBC W/Diff. .. I was low in 5 areas and know that it has something to do with anemia. I know that I was anemic as a child and had to take vitamins... but I currently do not take any vitamins. I often experience fatigue and easy bruising. I was told that the numbers can tell what type of anemia I have... Does anyone have any knowledge of this?? Here are my numbers...
    Normal Range:
    WBC 6.9
    RBC 5.67
    PLT 337
    NEUTROPHIL % 74
    LYMPSH % 26

    Low:
    HBG 10.8
    HCT 34.0
    MCV 60.0
    MCH 19
    MCHC 31.8

    Thanks!
    Christy

     
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    Old 05-16-2008, 08:33 PM   #2
    hermes370
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    Re: CBC numbers

    anemia work ups are fun and for the most part relatively straight forward ...

    in your case you hemoglobin/hematocrit, which are relative measures to determine if your anemic are both low, so by definition you are anemic

    next you want to look at your MCV(mean corpuscular volume - red cell volume), your's is low, so by definition you have a microcytic anemia

    you then can look at your MCH(mean corpuscular hemoglobin - how much oxygen carrying hemoglobin your red blood cells have - basically how red your red cells are), and your's is also low, so you have a microcytic, hypochromic anemia - small, pale, low number of red cells ... the MCHC is very similar to MCH, don't sweat details of the MCHC as it doesn't add much to your analsysis

    the differential for a microcytic, hypochromic anemia is several fold like iron deficiency, thalassemias, lead poisoning related, sideroblastic, porphyric, sometimes anemia of chronic disease/inflammation

    looking at other factors, the mentzer index is another way to figure out what type of anemia you may have .. it a ratio of the MCV/RBC and it's interpreted along the lines such that if the ratio is greater than or equal to 13 iron deficiency anemia is more likely, if its less than 13, then thalassemia is more likely .. and with your numbers, your index is 10, suggestive of thalassemia ... can I ask, where are you from, as in heritage

    but you're missing other measures necessary to better determine the type of anemia you have like a reticulocyte count, iron studies including ferritin, looking at your peripheral smear(based on those results it may push your MD to look at hemoglobin electrophoresis/special staining of your smear/etc) ... also wouldn't hurt to have an RDW to see what the variation in your red cell size is .. do you have a history of heavy periods or black stools(melena) or bright red blood per rectum ... do you have a family h/o anemia ...

    as a note of interest, thalassemics can have bleeding tendencies .. people also with low platlets can bleed more readily but your platlet numbers are normal ... but may be possible the easily bleeding/bruisability is unrelated to your anemia .. there are many undiagnosed von willebrands patients out there .. and it would be good to know what your coagulation studies show(PT/PTT/INR)

    hope that helps, and best of luck

    Last edited by hermes370; 05-16-2008 at 08:35 PM.

     
    Old 05-17-2008, 06:09 AM   #3
    cdavis1980
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    Re: CBC numbers

    Thank you for replying. I am caucasian...My family is a large mix! (Italian, German, French, on my Dad's side and on my mom's too many to list.) I also just found out that my twin brother, my dad, and my grandfather all have thalassemia. That is the reason I had some blood tests done in the first place. Is it hereditary? Do you think I need to have some more tests done?

     
    Old 05-17-2008, 07:33 AM   #4
    hermes370
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    Re: CBC numbers

    it would be good to characterize your anemia, but if it turns out to be thalassemia, with your numbers, it's going to be minor or trait and really only going to require folic acid supplementation, iron supplementation only if your deficient and you going about your own business ...

    from this point on it should be a relatively straight forward work up for your PCP

     
    Old 09-16-2008, 09:10 AM   #5
    Nelly2010
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    Re: CBC numbers

    Quote:
    Originally Posted by hermes370 View Post
    anemia work ups are fun and for the most part relatively straight forward ...

    in your case you hemoglobin/hematocrit, which are relative measures to determine if your anemic are both low, so by definition you are anemic

    next you want to look at your MCV(mean corpuscular volume - red cell volume), your's is low, so by definition you have a microcytic anemia

    you then can look at your MCH(mean corpuscular hemoglobin - how much oxygen carrying hemoglobin your red blood cells have - basically how red your red cells are), and your's is also low, so you have a microcytic, hypochromic anemia - small, pale, low number of red cells ... the MCHC is very similar to MCH, don't sweat details of the MCHC as it doesn't add much to your analsysis

    the differential for a microcytic, hypochromic anemia is several fold like iron deficiency, thalassemias, lead poisoning related, sideroblastic, porphyric, sometimes anemia of chronic disease/inflammation

    looking at other factors, the mentzer index is another way to figure out what type of anemia you may have .. it a ratio of the MCV/RBC and it's interpreted along the lines such that if the ratio is greater than or equal to 13 iron deficiency anemia is more likely, if its less than 13, then thalassemia is more likely .. and with your numbers, your index is 10, suggestive of thalassemia ... can I ask, where are you from, as in heritage

    but you're missing other measures necessary to better determine the type of anemia you have like a reticulocyte count, iron studies including ferritin, looking at your peripheral smear(based on those results it may push your MD to look at hemoglobin electrophoresis/special staining of your smear/etc) ... also wouldn't hurt to have an RDW to see what the variation in your red cell size is .. do you have a history of heavy periods or black stools(melena) or bright red blood per rectum ... do you have a family h/o anemia ...

    as a note of interest, thalassemics can have bleeding tendencies .. people also with low platlets can bleed more readily but your platlet numbers are normal ... but may be possible the easily bleeding/bruisability is unrelated to your anemia .. there are many undiagnosed von willebrands patients out there .. and it would be good to know what your coagulation studies show(PT/PTT/INR)

    hope that helps, and best of luck
    Ok, what about unusual and spontaneous bruising and petechiae with bruises that never really fade away (shadows left in skin), low MCV, huge platelets which have always been high but are starting to decline otherwise indices are fairly nml, always slightly elevated LD, and hist of breast CA treated with arithromycin and cytoxan. Got any ideas on that one because no one else seems to including my oncologist.

     
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