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Forum Name: Hematology Topics

Question: Post RNY Gastric Bypass Anemia


 jaxfla1 - Thu Nov 17, 2005 9:44 pm

I do not understand why RBC CD,HGB CD,HCT CD low while b12, folate,total Iron, Ferritin,Reticulocyte,Absolute are all WNL.

I just had a repeat of Blood tests due to checking for Anemia and both came back low Red Blood count. What SHOULD I DO NEXT?

RNY Gastric bypass 20 months ago no complications.
current vitals
BP 100/60
Height 5'11 Weight 171
B-12 455
Reticulocyte 27060 (25000-90000)
Iron total 102 (40-190)
Folate Serum 18 (>5.4 normal)
ferritin 95 (20-380)
WBC-woc 6.31 (3.80-10.80)
RBC cd 4.2 (4.40-5.80)
HGB cd 13.2 (13.8-17.2)
HCT cd 37.90 (41.00-50.00)
[/b]
 Dr. Tamer Fouad - Fri Jan 27, 2006 2:44 am

User avatar Hello,

The serum ferritin test is ordered to see how much iron your body has stored for future use. Reduced serum ferritin concentration is the most useful test for diagnosis of iron deficiency.[1] As the body iron stores decrease so does the serum ferritin. A serum ferritin concentration below 12 ug/L is virtually diagnostic of absent iron stores.

On the other hand, a normal serum ferritin concentration does not confirm the presence of storage iron, because serum ferritin concentration may be increased independently of body iron by infection, inflammation, liver disease, malignancy, and other conditions.[2]

Some patients with gastric disease or prior gastric surgery require special treatment with parentral iron, since the gastric retention capacity may be reduced. The retention capacity is necessary for dissolving the shell of the iron tablet before the release of iron.

References:
==========
1. Goddard AF, McIntyre AS, Scott BB: Guidelines for the management of iron deficiency anaemia. British Society of Gastroenterology. Gut 46(suppl 3-4):IV1, 2000.
2. Cook J: The nutritional assessment of iron status. Arch Latinoam Nutr 49:11S, 1999.

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