What Does High RBC Count Signify?

Posted on Mon, 28 Apr 2014

Question: I am XXXX/ Male/ 51 Yrs from India. My blood report for past few years indicates large number of RBC. No deficiency in Iron. I have got Asthma, High BP, Hypothyroid and Initial Diabetic and do take regular medicines. Latest report on the above count is as under- TEST NAME VALUE UNITS REFERENCE RANGE NAME DR. OF SELF MR XXXXXXX XXXXXXX (51Y/M) REF. BY TEST ASKED BLOOD ELEMENT ANALYSIS PROFILE,HBA,HEMOGRAM - 6 PART (DIFF) : : : SAMPLE COLLECTED AT : FLAT NO- 302, BLOCK- FF, XXXXXXX BARI COMPLEX, OPP. FIRE BRIGADE STATION, PATULI, EM BYPASS ROAD, KOLKATA- 700094 - 700094 X 10³ / µL 10.56 4 - 10 TOTAL LEUCOCYTES COUNT % 61.4 40-80 NEUTROPHILS % 28.38 M:20-40; F:20-40 LYMPHOCYTE PERCENTAGE % 3.5 0-10 MONOCYTES % 5.8 0-6 EOSINOPHILS % 0.2 < 1-2 BASOPHILS % 0.3 Male : 0-0.5 Female: 0-0.4 IMMATURE GRANULOCYTE PERCENTAGE(IG%) X 10³ / µL 6.48 2.0 - 7.0 NEUTROPHILS - ABSOLUTE COUNT X 10³ / µL 3 1.00 - 3.00 LYMPHOCYTES - ABSOLUTE COUNT X 10³ / µL 0.37 0.20 - 1.00 MONOCYTES - ABSOLUTE COUNT X 10³ / µL 0.02 0.02 - 0.10 BASOPHILS - ABSOLUTE COUNT X 10³ / µL 0.61 0.02 - 0.50 EOSINOPHILS - ABSOLUTE COUNT X 10³ / µL 0.03 0.03 IMMATURE GRANULOCYTES(IG) X 10^6/µL 7.64 Male : 4.5-5.5 Female : 3.9-4.8 TOTAL RBC X 10³ / µL Nil Nil in adults NUCLEATED RED BLOOD CELLS % Nil Nil in adults NUCLEATED RED BLOOD CELLS % g/dL 13.6 Male : 13-17 Female : 12-15 HEMOGLOBIN % 49.7 Male : 40-50 Female : 36-46 HEMATOCRIT(PCV) fL 65.1 83-101 MEAN CORPUSCULAR VOLUME(MCV) pq 17.8 27-32 MEAN CORPUSCULAR HEMOGLOBIN(MCH) g/dL 27.4 31.5-34.5 MEAN CORP.HEMO.CONC(MCHC) fL 43.6 39 - 46 RED CELL DISTRIBUTION WIDTH - SD(RDW-SD) % 21.4 11.6-14 RED CELL DISTRIBUTION WIDTH (RDW-CV) fL 14.21 9.6-15.2 PLATELET DISTRIBUTION WIDTH(PDW) fL 9.8 6.5-12.0 MEAN PLATELET VOLUME(MPV) X 10³ / µL 342 150-400 PLATELET COUNT % 36 19.7 - 42.4 PLATELET TO LARGE CELL RATIO(PLCR) % 0.25 0.19 - 0.39 PLATELETCRIT(PCT) : Alert!!! RBCs:Marked anisocytosis moderate poikilocytosis. Predominantly microcytic hypochromic cells with ovalocytes & elliptocytes Advised: Vitamin B12/ Folic Acid estimation. Can you guide me?? I also have high hsCRP (5.3) and it was same about 6 months before, when I had severe back pain (Middle portion). I had to take D3 supplements, as it was about 11. Now it is 30. I have get chest pain some times. Mild Stiffening of one (Right) valve (Calcification). Left Ventricle is about 60% efficient. I am NOT getting holistic picture. If all related reports can be sent to you? I am in Bank's job in IT area. No physical work and long hours of office sitting. I get VERY much tired and so can NOT have walks etc. Kindly guide me.... Regards.../ 01.April.2014

Answered by Dr. Indu Kumar (55 minutes later)

Brief Answer: You are suffering from Polycythemia. Detailed Answer: Hello XXXX Thanks for writing to HCM I have gone through your history and reports in detail. Your R.B.C count is increased and it signifies Polycythemia.In your case most likely it is related to chronic respiratory disorder.Chronic respiratory disorder causes chronic hypoxia and our body naturally compensates chronic hypoxia(less oxygen)by increasing the number of R.B.C so that sufficient oxygen reaches to the cells. Mild cases of polycythemia may not cause symptoms but some patients may experience blurred vision,chest pain,headache,muscle pain,dizziness etc. Peripheral smear shows marked anisocytosis,moderate poikilocytosis. Predominantly microcytic hypochromic cells with ovalocytes & elliptocytes.It is right that it may be due to lack of Vitamin B12 and folic acid,so these should be investigated and if there is deficiency of these factors,it should be corrected. Your TSH is also increased.You can increase eltroxin dose to 50 microgram/day.It should be taken half hour before breakfast. Increased CRP is not related to any cardiac problem.It may be linked to chronic respiratory infection.It doesn't require any active management. Your cardiac status is normal.ECHO findings are satisfactory.Lipid profile is also normal.It is good that diabetes mellitus is controlled. You should take medicines regularly and try to increase your physical activity in the form of walking and exercise. You should take lot of fruits and vegetables in your diet. Get well soon. Hope I have answered your question. Further queries are most welcome. Take Care Dr.Indu XXXXXXX

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