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Have low hemoglobin. Done smear study. Any problem?

I am hemalatha 42 years.i am having low heamoglobin of 6.7 hematocrit 23.3,mcv 59,mch17.0,mchc28.6,rdw22.6 and my leukocytes are all in normal ranges.platelets also in normal.but smear study saysmicrocytic and hyprochromic in appearance,elongatedand teardrop shaped red cells are seen.This is my report. Next week only I got an appointment with my Doctor. Before that I want to know whether there is any problem in my reports. Please suggest me.Thankyou
Asked On : Sun, 24 Mar 2013
Answers:  4 Views:  160
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Internal Medicine Specialist 's  Response

Thanks for being with HCM.
Microcytic hypochromic red blood cells means red blood cells are small in size and amount of hemoglobin inside the cells is less.

Slight variation in size and shape that is also called anisocytosis and poikilocytosis.

You have Hemoglobin of 6.7 gm%,hematocrit 23.3,mcv 59,mch17.0,mchc 28.6,rdw 22.6 and normal leukocytes and platelets.
These changes can be seen in:
1.iron deficiency anaemia
2.chronic blood loss due to peptic ulcer,hemorrhoids,heavy menstruation,etc
3.Anaemia of chronic disease such as chronic kidney disease,tuberculosis,malabsorption.

You need to go further testing with serum iron studies and other investigations for cause of iron deficiency and treatment with iron supplement as per the physician's opinion.

Hope this could help you.

Wish you good health.
Answered: Mon, 25 Mar 2013
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General & Family Physician Dr. Jay Patel's  Response

Based on the information the Hemoglobin is VERY LOW - normal needs to be between 11-13 gm% and yours is 6.7 gm%. It falls in classification as "SEVERE TYPE anemia"

Now let me try and put some light on the report and what we mean by it.
1) Hypochromic - Low iron content in Red blood cells
2) Microcytic - Small cell size compare to normal
3) Anisopoikilocytosis - Various size and shape of cell seen different the normal cell shape
4) Target cell- the cell seems to be like bull eye target with circle - normal is discoidal shape
5) Tear drop - looks like drop shape which is abnormal - normal is discoidal shape.

Now for the report it seem as the problem is SOME WHERE IN THE STEM CELLS which produces the RED BLOOD CELL STREAM as the other CELL linage like leukocytes and the platelets are normal per the report.

Probable diagnosis : - selective red blood cell production (erythropoeisis) problem


CONSULT - HEMATOLOGIST (blood specialist / doctor)
here is what physician mostly will do
1) Physical exam
2) May repeat the blood work,
3) May ask for bone marrow biopsy - to check on stem cell (cell from which different cell can be made/parent cell in short)

TREATMENT : will be based on the finding, if nothing except the problem with red cell linage found the ERYTHROPOTIN- stimulate the red cell linage will be given and will keep you under follow up for some time

Answered: Sun, 24 Mar 2013
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  User's Response

You are having microcytic and hyprochromic anaemia with tear drop shaped red blood cell.

Most common cause is Iron deficiency anemia
Other causes:
Sideroblastic anemia
Lead poisoning
Anemia of chronic disease

Tear drop shaped red blood cell can be due to:
Leukoerythroblastic anemia
Thalassemia major
Severe iron deficiency

I think you should go for Iron Levels in your blood like S. Ferritin, TIBC, etc

I think That will help

Best wishes
Answered: Sun, 24 Mar 2013
Internal Medicine Specialist Dr. Omer's  Response
Answered: Mon, 25 Mar 2013
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