My RBC, WBC, and hemoglobin count are low. Is it something serious?

Hello,

Welcome to icliniq.com.

Yes, you should be concerned about it. It is showing a decrease in all the three cell lines so it is moving towards pancytopenia. I guess there is no history of such problems in the family.

There are multiple causes for this, and common is vitamin B12 deficiency and followed by bone marrow problems, lupus, and others. You mentioned lupus. Is it a confirmed diagnosis in you? Were you evaluated for this with blood test like ANA (anti-nuclear antibody), Anti-dsDNA, etc? Your symptoms may be explained by low hemoglobin.

Now, for chest pain, due to pain on exertion or at rest, for how long does it persist? Any relation to meals, deep breathing, etc. It may occur due to gastroesophageal reflux disease. So firstly, along with hemogram you should have peripheral blood film done, which would show the morphology of cells. Also, the values must have been mentioned in current hemogram like MCV, MCHC, MCH, etc. So, please attach your report for analysis, which would point towards the cause. So investigations needed, peripheral blood film, thyroid profile, vitamin B12 and folic acid, serum iron studies, vitamin D, which will help in finding the cause.

Hello,

Welcome back to icliniq.com.

So, your chest pain is pleuritic in nature, which means there is an inflammation involving the lining of the lungs. This is called as serositis and it is a known and common manifestation of lupus. You may have OTC (over the counter) for these like Paracetamol or Ibuprofen. Next, your blood picture is suggestive of macrocytic anemia which has multiple causes including vitamin B12 deficiency. You mentioned, vitamin B12 as more than 60. Is it correct? I mean the usual unit for B12 is pg/mL.

So the deficiency is considered for a level below 200, so please confirm its units and reference range there. And deficiency is very well possible and can cause pancytopenia in lupus patients. So if it is there, then you need to be on supplements like tablet ME12 (Methylcobalamin) OD (once daily) for correction of the deficiency. If there is no deficiency, then you will need Folic acid levels followed by bone marrow examination. Keep track of cell lines.

Next is vitamin D and calcium, both are low. Your body pains are due to this. So need to be on supplements, like tablet Uprise D3 or Calcirol sachet (Cholecalciferol) 60,000 units once a week for eight weeks then once a month for six months. Also, should be on tablet Calcium carbonate like Shelcal 500 mg twice a day until correction of vitamin D deficiency. Also, sit in the morning sunlight and increase milk intake if possible for you.