Q. Why do I have persistently high Hb and HCT?
Hi doctor,
I am a 31-year-old female. I have a history of celiac disease and a past medical history of Hodgkin's lymphoma, a stage 2 cervical lymph node and tumors in my chest. I had a blood test last week which showed B12 and Folic Acid deficiency, raised hemoglobin of 161 and raised hematocrit of 0.465. I have had a persistently elevated hemoglobin for three years but has never been as high as 161. It varied between the levels of 144 to 157. My doctor is concerned about my current reading of 161, as I have celiac disease. Can you offer me any advice? I am concerned about Hodgkin's disease occurrence or that I may have polycythemia vera.
Thank you.
Hi,
Welcome to icliniq.com.
- You are having celiac disease in which because of malabsorption vitamin B12 deficiency and folate deficiency can occur. This deficiency also can be developed if polycythemia present in which proliferation more.
- Here hemoglobin and HCT is high as per history. Hence if it is persistently elevated, then polycythemia, a form of blood cancer, should be ruled out. For that one molecular investigation useful that is the detection of JAK2 mutation.
- If polycythemia confirmed, then phlebotomy is done regularly and other suitable medication prescribed like Anagrelide that prevents thrombosis in such case if platelet count also high in CBC.
- Rule out metastatic Hodgkin's lymphoma also as you have a history by CT scan and bone marrow biopsy study.
- Celiac disease is a form of autoimmune disease and gluten-free diet prescribed for that.
Take care. Consult nearby oncologist for examination with keeping all this in mind.
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