What are the causes of elevated Hb and RBC levels?

Hello,

Welcome to icliniq.com.

I understand your concern.

I would like to review all your reports, particularly due to the high levels of hemoglobin (Hb) you previously had. Since your bone marrow function appeared inadequate, you may require a repeat bone marrow biopsy for further evaluation. There are several secondary causes of high Hb, including tumors, high-altitude living, smoking, dehydration, and certain kidney-related conditions. It would be helpful to know if you have undergone an abdominal ultrasound and the current status of your spleen.

If your Hb remains above 16.5, you may need to continue phlebotomy every three to six months. However, at present, your Hb is lower following the phlebotomy. Regular follow-ups with a complete blood count (CBC) and a new bone marrow report will be necessary. Polycythemia vera could be a potential cause of your elevated Hb, but further evaluation is needed. A comprehensive panel for myeloproliferative neoplasms (MPNs) should be conducted, including tests for JAK2 Exon 12, MPL, and CALR mutations. Additionally, a bone marrow examination by an expert is recommended.

Until a definitive diagnosis is established, phlebotomy remains the primary management approach.

I hope I have addressed your concerns. Feel free to reach out if you have further questions or need additional guidance.

Wishing you good health.

Thank you.

Hello,

Welcome back to icliniq.com.

You need to repeat the bone marrow biopsy, as it is essential for analyzing polycythemia vera.

I hope this answers your question.

Thank you.