HomeAnswersPathologypolycythemia veraMy annual health checkup reports indicate a high RBC count. What does it mean?

What does it indicate if a person has a high RBC count?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. K. Shobana

Published At November 30, 2022
Reviewed AtAugust 8, 2023

Patient's Query

Hello doctor,

I have attached a report as part of my regular annual check-up. My free RBC (red blood cell) indicators are very high, and when I researched a bit, it pointed to PCV (packed cell volume) and leukemia. I am apprehensive. As a follow-up, I also tested for LDH (Lactate dehydrogenase). It was average at 172. Please tell me what your opinion is. I am scared.

Hi,

Welcome to icliniq.com.

I understand your concern. Following is my opinion of your asked questions. I have seen the attached report (attachments removed to protect the patient's identity). It shows borderline high hemoglobin, high PCV, and RBC mass. So it could be polycythemia. But it does not necessarily indicate any cancer. Dehydration, smoking, lung disease, and cardiac disease can cause secondary polycythemia. So let me know if any of such history is present. Your lymphocyte count is also high, usually seen in some chronic inflammation or viral infection. Consider drinking lots of water, and if any smoking habit or clinical complaint is present, let me know. It would help if you repeated your CBC (complete blood count) after a few days to check your lymphocyte count and hematocrit value again after a few days. Peripheral smear report shows normal morphology of white blood cells, so the blood cancer possibility is less. Hope this information will help you. Let me know if you have more questions in mind. Thank you.

Patient's Query

Hello doctor,

Thank you for the reply. I do not smoke now. I quit two years ago and have not smoked after that. I also got an LDH (Lactate dehydrogenase) test done. It was 178 IU/L. Regarding polycythemia, is it some form of blood cancer? What should I do about it? I do not have any viral infection symptoms for many months now. I am average and working out fine. So is polycythemia cancer or a disorder? Please guide me on the next steps. Thank you.

Hello,

Welcome back to icliniq.com.

The following are my different opinions. Polycythemia is of two types. Primary polycythemia is a blood cancer, and secondary polycythemia is a benign disorder secondary to causes, as mentioned in the previous answer. Consider drinking lots of water and investigating with chest X-ray and EKG (electrocardiogram) to rule out secondary polycythemia. After a few days, repeat your CBC (complete blood count). Suppose hemoglobin, RBC (red blood cells), and PCV (packed cell volume) is elevated after a few days. In that case, serum EPO (erythropoietin) estimation, bone marrow aspiration, and further investigation are needed, for which you need to visit a hematologist. Hope this helps. Kindly revert for further queries. Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Goswami Parth Rajendragiri
Dr. Goswami Parth Rajendragiri

Pathology

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