Patient's Query
Hello doctor,
I have concerns regarding my mother's anemia treatment. She is currently under medications for hypothyroidism (Eltroxin 50 mcg), hypertension (Olmezest 20mg), and Osteoarthritis (stage-2) of knee joints (Gemcal D3) along with Ecod plus as a multivitamin. Recently as part of a few routine tests, she was diagnosed with mild anemia (Hb 10.8) with smear reporting citing RBCs: Mild anisopoikilocytosis. Predominantly macrocytic normochromic. Platelets appear mildly reduced in the smear. Macroplatelets are seen. Based on this report, the medicine doctor asked for ferritin (100 ng/ml), B12 (894 pg/ml), and RBC folate (883 ng/ml) reports, all of which came normal. So, he asked for CBC from a different laboratory, and although the Hb is again low (10.7), the rest of the results are quite different from the initial one. Even the indication in the smear report is different RBC- Mild hypochromic. The platelet is adequate. We are now completely confused about which way to take. I have attached her initial kidney, thyroid, lipid, and CBC reports along with the repeated CBC one.
Kindly help.
Hello,
Welcome to icliniq.com.
After going through all the clinical details and investigation reports (attachments removed to protect the patient's identity) of your mother, it looks like she has mild anemia with chronic diseases (hypothyroidism, osteoarthritis, and hypertension). Mild anemia is expected in people with such chronic diseases which are called anemia of chronic disease, but in that case, the peripheral smear usually shows normal-sized RBCs. Such large RBC (macrocytic) can be seen in many other conditions, common among them would be vitamin B12 and folic acid deficiency. Both reports are normal.
I would prefer you to get some more blood investigations to look for the cause.
These above tests will help us to see the activity in the bone marrow and detect the possibility of peripheral destruction of RBC. The last option would be to do a bone marrow study to see the production of blood.
I hope this has helped you. Thank you.
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Answered byDr. Veerendra Channabasappa Patil
Medically reviewed byiCliniq medical review team
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