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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes low hematocrit level despite a normal endoscopy?

68 yr old white male. My hematocrit dropped suddenly 4 years ago, from 42 to hovering around 31. Cells are not maturing. Endoscopy, colonoscopy and bone marrow were negative. Generally healthy. Not symptomatic. Exercise regularly. Not low enough for transfusion therapy. No kidney disease. Iron is abundant. O2 saturation 97%. Is there a protocol to stimulate red cell production/maturity?
Fri, 29 Dec 2017
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Hematologist 's  Response
Hi,
This is a tricky situation. You may actually be having a maturation defect or a myelodysplastic syndrome. Needs a repeat BM Aspiration, Trephine Biopsy with Cytogenetics and a few other tests (FISH/PCR-based). Once we have ruled that out I think we can observe your counts at a certain interval to know the trend of your blood counts.
Hope this helps.
Regards,
Dr. Arijit Nag
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