Q. Can you see the attached CBC report, and let me know if there is anything serious ?

Answered by
Dr. Parth R Goswami
and medically reviewed by iCliniq medical review team.
Published on Jun 27, 2018 and last reviewed on: Oct 09, 2018

Hi doctor,

My wife's iron and ferritin were low, so the doctor ordered CBC. CBC showed low WBC, high monocytes, and high RBC, which is what made us scared.

She has schistocytes and elliptocytes among other RBC morphologies. We read about it and are very worried, and she had a C-section three years back. Her iron is 13 ug/dL, iron binding is 484 ug/dL, iron saturation is 3 %, and ferritin is 3 ng/mL. I have attached her CBC report.

Are her reports indicative of something serious?

She also has pain between her legs and the pelvic area. She has vitamin D deficiency and vitamin B12 deficiency. She also had iron-deficiency anemia in the past, for which she took Ferrous sulfate. She is currently taking vitamin D and Thyrax medicines.

Dr. Parth R Goswami

Hematology Pathology
#

Hello,

Welcome to icliniq.com.

I have gone through your wife's reports (attachment removed to protect patient identity).

The report shows schistocytes, which are fragmented RBC (red blood cell), commonly seen in hemolytic anemia. So, to rule out hemolysis, serum LDH (lactate dehydrogenase), reticulocyte count, and serum bilirubin should be tested.

If hemoglobinopathy is suspected, then HPLC (high-performance liquid chromatography) can be done.

As there is a history of iron-deficiency anemia (IDA), which decreases the iron level and increases TIBC (total iron binding capacity). So, treatment for IDA should be started with iron tablets like Ferrous sulfate or iron injections.

Her monocyte count is slightly elevated, but absolute monocyte count is more important which is within the normal limits.

Total WBC count is low, which can be due to any drug, infections like tuberculosis, typhoid, parvovirus B19, temporary infection, EBV (Epstein-Barr) virus infection, etc. Hence for that clinical examination and correlation has to be done.

But in smear, no abnormal cells are seen, so there is nothing alarmingly wrong.

Continue treatment for iron-deficiency anemia. Repeat peripheral smear after ten to twenty days and follow-up.

Revert after twenty days to a hematologist online --> https://www.icliniq.com/ask-a-doctor-online/hematologist

Also Read Answers From:

Related Questions & Answers


How to treat iron deficiency anemia?

Query: Hi doctor, My daughter is 13 years old. She is having moderate to severe stomach pain for a year. We thought that it was related to constipation. After a few weeks, my daughter started to have a headache, feeling of dizziness, and shortness of breath. She had a habit of eating ice all the time. Her...  Read Full »

Do I need vitamin D and iron supplement?

Query: Hi doctor, My 25-OH vitamin D total CLIA test showed result of 13.36 ng/mL. What supplement should I start and for how long? Also my iron is 41.2. Do I need a supplement?  Read Full »

I am anemic even after taking iron supplements. Why?

Query: Hi doctor, I have a history of anemia. I have been taking iron supplements prescribed by my doctor for the past few months. After a while, I had an appointment, and my doctor said that I am still very anemic. A few years ago, I had an eating problem. I was overeating, but I did not gain weight. Is t...  Read Full »

Popular

Popular

Ask your health query to a doctor online?

Ask a Hematologist Now

* guaranteed answer within 4 hours.
Enter Your Health Query
You can upload files and images in the next step.

Fee:  

 


Disclaimer: All health Q&As published on this website is not intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek the advice from your physician or other qualified health-care providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website.