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Q. Kindly explain the treatment looking at my father's blood report.

Answered by
Dr. Prakash H Muddegowda
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Sep 25, 2016 and last reviewed on: Sep 01, 2020

Hi doctor,

I would like to get a consultation regarding my father. His blood report showed hemoglobin (optical/impedance) 12.4 g%, platelet count (optical/impedance) 93 10^3/cubic mm, WBC count (optical/impedance) 3.6 10^3/cubic mm, packed cell volume (calculated) 36%, serum vitamin B 12 472 ng/L. Please let me know the treatment for this.

Dr. Prakash H Muddegowda

Geriatrics Hematology Pathology
#

Hi,

Welcome to icliniq.com.

Based on your query, my opinion is as follows.

  • There are mild anemia, low white blood cell count and low platelet count. All counts are considered adequate clinically, as they are near normal.
  • It could be early features of megaloblastic anemia. As vitamin B12 levels are normal, it could be due to folic acid deficiency. Both are necessary for nuclear maturation.
  • As both are water soluble vitamins, there is no risk of toxicity. Supplements of folic acid and also B12 can be started now for three months twice daily. Green leafy vegetables are also a good source of these vitamins.
  • Repeat blood tests after three months. If alcohol is being taken, then it should be avoided.

The Probable causes:

Folic acid deficiency.

Treatment plan:

Folic acid and vitamin B 12 supplements.

Regarding follow up:

Revert back after three months to a hematologist online.---> https://www.icliniq.com/ask-a-doctor-online/hematologist


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Thank you very much for the detailed explanation doctor.

Dr. Prakash H Muddegowda

Geriatrics Hematology Pathology
#

Hi,

Welcome back to icliniq.com.

  • You are welcome. Do start supplements and get back after three months.

Revert back after three months to a hematologist online --> https://www.icliniq.com/ask-a-doctor-online/hematologist


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Thank you doctor,

I have one more doubt. Is there any problem in the detailed report?

Dr. Prakash H Muddegowda

Geriatrics Hematology Pathology
#

Hi,

Welcome back to icliniq.com.

After going through the report (attachment removed to protect patient identity), my opinion is as follows:

  • Other than routine hematological tests, I found two other things abnormal. The most important one is abnormal glycosylated hemoglobin and increased postprandial plasma glucose levels.
  • If your father is already diabetic, then the glycosylated hemoglobin, which indicates three months glucose control is near excellent values.
  • If this is the first time, then looking at both values, your father might be borderline diabetic and there is a possibility that he will develop diabetes mellitus in the near future. Possible lifestyle management is necessary. Medications will be necessary at a later date.
  • Serum gamma-glutamyl transpeptidase level is mildly elevated. This is commonly related to alcohol. He needs to avoid alcohol or restrict as much as possible.
  • The conjugated serum bilirubin is a bit high and not worrisome. It could be possibly related to it.
  • Diabetologist opinion will be necessary, if not already being taken to manage lifestyle modifications. The other values are not to be worried about for now.

The Probable causes:

1. Glucose intolerance, if not diabetic.
2. If diabetic, then good control.

Preventive measures:

Lifestyle modification.

Regarding follow up:

For further doubts consult a hematologist online.---> https://www.icliniq.com/ask-a-doctor-online/hematologist


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