What causes increased hemoglobin and decreased platelet?

Question

Hi doctor,

My hemoglobin level increased from 15 to 17, and platelet count decreased from 3.1 to 1.4*10^3 per microliter of blood in the last five months. The only symptom I have is occasional skin itching.

Answer 1

Hi,

Welcome to icliniq.com.

As your platelet count decreased over four months duration, chronic infection, and drug history have to be ruled out first.
If they are not causative then a detailed investigation plan should be decided according to the examinations as follows:

1. ESR (erythrocyte sedimentation rate) or CRP (C-reactive protein).
2. Blood culture.
3. Alcohol history.
4. Peripheral smear examination.
5. Renal profiles such as uremia might lead to decreased platelet count.

Your hematocrit should be checked. If it is high and RBC (red blood cell) mass is elevated with persistently elevated hemoglobin over 18, then the JAK2 mutation has to be tested to rule out the myeloproliferative disorder. According to the cause, further specific treatment will be given. Hence, first, consult your physician for examination and get your liver and spleen examined by the doctor. Then, get a proper workup planned according to the need.

Take care.