My hematocrit, RBC, Hb, and mean cell volume are elevated. Please help.

Question

Hello doctor,

I have been feeling unwell for a long time. These are my recent blood test results. My doctor said that the values of my hematocrit, RBC count, hemoglobin, and mean cell volume have been out of the normal range for at least 10 years, as far as he could guess.

I think it should be investigated. What do you suggest? The results of the blood test are as follows:

Hemoglobin concentration-161 g/L [120.0 to 150.0].
Total white blood count- 9600/µL [4.0 to 10.0].
Platelet count - observation 327000/µL [150.0 to 450.0].
Hematocrit- 0.491 l/l [0.36 to 0.46].
Mean cell volume- 83.8 fL [83.0 to 101.0].
Mean cell hemoglobin level- 27.5 pg [27.0 to 32.0].
Mean cell hemoglobin concentration- 328 g/L [315.0 to 345.0].
Red blood cell distribution width- 12.5 % [11.6 to 14.0].
Red blood cell count- 5.86x106/µL [3.8 to 4.8].
Neutrophil count- 6300 /µL [2.0 to 7.0].
Lymphocyte count- 2600 /µL [1.1 to 3.5].
Monocyte count- observation 500/µL [0.2 to 1.0].
Eosinophil count- observation 200 /µL [0.0 to 0.5].
Basophil count- 100 /µL [0.0 to 0.1].
Percentage neutrophil count- 66 %.
Percentage lymphocyte count- 27 %.
Percentage monocyte count- 5 %.
Percentage eosinophil count- 2 %.
Percentage basophil count- 1 %.

I am currently taking tablets Sertraline, Cerelle, and Omeprazole.

Please help.

Answer 1

Hello,

Welcome to icliniq.com.

We value the high level of confidence that you have in us.

Your hemoglobin and hematocrit values are slightly high. Your RBC count is only marginally elevated since the upper limit of the normal range is 5.5 million/cu.mm.

From these values, I have a suspicion that you might have hemochromatosis or an early-stage polycythemia vera. In hemochromatosis, there is iron overload, and the two main tests required for diagnosis are serum ferritin and serum transferrin saturation. Genetic testing is confirmatory.

For polycythemia vera, the red cell mass needs to be determined, and preferably, a bone marrow biopsy is required. In addition to the elevated hemoglobin and hematocrit, it is also important to review your platelet count and white blood cell count, as these may be elevated in some patients with polycythemia vera. Testing for the JAK2 gene is confirmatory. It is better to get these conditions ruled out since they require treatment.

I hope it helped.

Please feel free to reach out to me again in case of any further queries.

Thank you.