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.
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 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.
Revert in case of further queries.
Hi doctor,
Thank you very much for the detailed explanation.
Hi,
Welcome back to icliniq.com.
You are welcome. Do start supplements and get back after three months.
Hi doctor,
Thanks for your reply. I have one more doubt. Is there any problem in the detailed report?
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 is abnormal glycosylated hemoglobin and increased postprandial plasma glucose levels. If your father already has diabetes, the glycosylated hemoglobin, which indicates three months of glucose control, is near excellent. 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 soon. 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 himself as much as possible. The conjugated serum bilirubin is a bit high and not problematic. It could be related to it. Diabetologist opinion will be necessary, if not already taken to manage lifestyle modifications. The other values are not to be worried about for now.
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