What Do The Following Test Results Indicate?

Posted on Sat, 30 May 2015

Sat, 30 May 2015 Answered on

Sat, 20 Jun 2015 Last reviewed on

Question : Hi, I had a CBC done in Nov.2014.The results were High Hemoglobin High Hematocrits and High RDW.I also had a swollen Spleen.Test was repeated in Jan.2015 with the same results.I have been feeling fatigued,very fatigued.My Blood Oxygen Level has been low around 89-95 for over a year.I am pain management patient due to a severe failed Spine Surgery in 2005 and the pain meds I am taking will be replaced by a pump to deliver meds directly into spine.I am at risk due to respiration problem with a low oxygen saturation.Could the blood tests results point to a problem I am not aware of.

Answered by Dr. Panagiotis Zografakis (12 minutes later)

Brief Answer:
They could

Detailed Answer:
Hello,

a high hematocrit and a 'swollen' spleen may mean polycythaemia vera (PV) but the diagnosis requires a really high hematocrit. Typically anything more than 48% is suspicious in females but commonly the patients have hematocrits as high as 60% or even more.

Patients with PV are prone to arterial and venous thrombosis and bleeding, so there is some risk for you if you do have this entity.

Your CBC report (and any other lab test you may have, including radiological tests like CT, MRI, ultrasound) may provide clues, so if you can, please upload them.

When there is suspicious for polycythaemia, secondary causes have to be excluded like pulmonary disease (the low oxygen saturation is suspicious). Erythropoietin can be measured and the result may be very helpful. If all secondary causes are excluded detecting the JAK2 gene mutation and having a low erythropoietin level would give us the diagnosis of PV.

I've gone a little too far perhaps because I haven't seen your reports, but I had to give you an insight of the diagnostic thoughts.

I'll be glad to comment on your reports too.

Kind Regards!

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Panagiotis Zografakis (3 hours later)

Thank You Dr..I have an iPad and therefore unable to download Labs or recent MRI.,MRI was to check for changes in Spine due to a bad fall last year.I am a little suspicious of abnormal labs and the rash from my feet up my lower legs.My 50 year sister passed away quickly from AML last year,8 mths after diagnosis.I am also Hypothyroid and have swollen lymph nodes around neck.I asked my PCP for a referal to an Endocrinologist but he thinks he can deal with my Thyroid condition.

I had a failed spine surgery in 2005 and sustained severe nerve damage.The medications I have been on have really taken its toll on my health.

Thank You for the reply.

Answered by Dr. Panagiotis Zografakis (15 minutes later)

Brief Answer:
Glad to help

Detailed Answer:
You're welcome.

I'm sorry about your sister. Her condition does not sound like yours at all.
Despite that the lymph nodes on the neck need investigation if they're larger than 1cm-1.5cm.
Hypothyroidism is not a very difficult situation for any doctor, so you shouldn't worry about it!

Kind Regards!

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar