What are the possible causes of high HB, RBC, and hematocrit levels?

Question

Hello doctor,

I am a 25-year-old male and have had high hemoglobin and RBC levels for over two years. Recently, I got a hemogram that again shows elevated RBC and Hb levels and hematocrit within normal. So my hematologist asked me for the JAK 2 exon mutation 12 and 14 tests. I am worried that I have polycythemia vera, and because of this, I have anxiety all day thinking of it. I am asymptomatic, and I do not live in hilly areas. Currently, I am taking Levothyroxine 25 mcg for hypothyroidism. Following are RBC, Hb, and hematocrit counts for a few tests in the last few years.

The previous year:

RBC : 5.72 x 10^6 per microliter of blood.

Hb: 17.4 gm/dL

Hematocrit: 49.8 %.

Following year:

RBC : 5.8 x 10^6 per microliter of blood.

Hb: 17 gm/dL.

Hematocrit: 49.4 %

Later:

RBC : 5.61 x 10^6 per microliter of blood.

Hb: 17 gm/dL.

Hematocrit: 49.1 %.

Can I have PV considered by RBC and Hb for the last two years?

Answer 1

Hi,

Welcome to icliniq.com.

Your Hb (hemoglobin), hematocrit, and RBC (red blood cells) are high. The diagnosis is either primary polycythemia vera or secondary polycythemia. I require your total WBC (white blood cell) count and platelet to comment further. You can attach your reports; if you have any cardiac or respiratory disease, secondary polycythemia is most likely. To provide a history of smoking, respiratory or cardiac cause if present. I suggest the following investigations for you.

1. EPO estimation (erythropoietin secretion rate estimation).

2. JAK2 (Janus Kinase 2) mutation and exon 12 studies by PCR (polymerase chain reaction).

If you have done EPO estimation, then also we can conclude further. I hope I have cleared all your doubts.

Thank you.

What are the possible causes of high HB, RBC, and hematocrit levels?

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