Patient's Query
Hello doctor,
My hemoglobin level is low. My ferritin level is at a high 959.7 mg/ml. My hemoglobin levels are the same even after taking three units of blood in the last month.
It is still 6 g/dl. Last month, my ESR was 32, and now it is 110, platelet count 128000 last month, and now it is 60000, WBC count 4300 last month, and now it is 2300. TSH is 1.79, and iron level is 238.5.
I am currently taking Folvite, Rifagut 400 mg, Dytor 5 mg, Xytid CV, Cremaffin plus 15 ml, Udiron 300 mg, Blong F, and injection Heliopenam.
Kindly guide.
Hello,
Welcome to icliniq.com.
I have read your reports (attachment removed to protect patient identity), and the following is my opinion on your asked question.
In your attached report, the reticulocyte count and bilirubin level are high. Ferritin is also high. Liver and spleen are enlarged in a USG (ultrasound) scan. So you could probably have hemolytic anemia.
In this condition, red blood cells are constantly being destroyed in our blood due to certain causes. Hence, the hemoglobin level goes down. Sometimes it includes a platelet component as well, so the platelet level can go down.
There are many causes for hemolytic anemia, like, for example, autoimmune hemolytic anemia, for which the Coombs test can be done. G6PD deficiency, spherocytosis, PNH (paroxysmal nocturnal hemoglobinuria), etc., are some other causes for hemolytic anemia. So you need to visit a nearby hematologist for a detailed physical examination, according to which a further management plan will be decided.
I hope this helps.
Thank you.
Patient's Query
Thank you, doctor,
I have visited a nearby hospital and consulted with a hematologist. He asked me for an Hb typing test, but as I received blood last month, I could not do that. He asked me to wait for three months and gave me some medicine like Folvite, Bevon, and some liver tonics.
In your opinion, what should I do in these three months' time?
Hello,
Welcome back to icliniq.com.
I have read your query and can understand your concern.
Your hemoglobin level is very low. So for hemolytic anemia, a full workup can be done. You can investigate with the Coombs test, ANA (antinuclear antibody) testing, and HB electrophoresis after a few weeks.
You have hemolytic anemia, but the cause is not clear, which you need to investigate in detail, especially with the Coombs test and HB electrophoresis. Additionally, a G6PD qualitative test can also be done. The management can be planned once the above reports are done.
I hope this helps.
Please feel free to reach out in case of further queries.
Thank you.
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