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Forum Name: Hematology Topics

Question: High RBC, HG, Hematocrits


 reyleejo - Thu Dec 29, 2005 4:19 pm

Husband has congenital heart disease, caused Secondary pulmonary hypertension. Went to doctor .. complaints of diarrhea, headache, constant hunger( eat dinner and be hungry again within the hour if that)dizziness, confusion(described as cloudy feeling... kinda like when you have medicine head, also abdominal pain around umbilucus area.. anyways his blood test results came back.
His RBC was 6.1
HG was 20
heamtocrit was 63.3

I know that his RBC will be high due to lack of oxygen, his o2 sat is 87 rest and in low 70's upon exertion.(such as walking).
But is this the cause of HG nad Hematocrit to be high as well?

His Blood Sugar was 59, they said he was hypoglycemic but are testing him on Jan 6th for Diabetes. (Glucose testing after 12 hr fast).

He is scheduled to go to a Hematologist on the 10th and a gastroenterologist after that.


What do you think?

Last year blood test results were also high but cardiologist was not concern with this , his results then were

heamtocrits 59
HG 19.7

what is the concern now? SHould they have been concerned last year?
 Dr. Tamer Fouad - Wed Jan 25, 2006 3:44 am

User avatar Hello,

I hope your husband is feeling better now.

Polycythemia is the term used to describe an abnormal increase in the number of RBCs. This condition leads to an increase in Hb, Hct, or RBC in the blood count test.

Secondary polycythemia can arise due to an appropriate bone marrow response to physiologic conditions, such as: high altitude, cardiopulmonary disorder and increased affinity for oxygen.

At a moderately raised Hct level of 60%, the whole-blood viscosity is 2.5- to 3-fold that of blood with a Hct of 40%.[1]

Hyperviscosity may lead to headache, fatigue, visual disturbances, and retinopathy.[2]

Thrombosis is the most common cause of mortality in polycythemia, accounting for 29% of the deaths. Cerebral vascular accidents were the most frequent (34%), followed by myocardial infarction (13%) and peripheral arterial occlusion (9%), whereas venous thrombosis accounted for 26% of these events.[3]

In patients with secondary erythrocytosis, corrective action may not be needed unless the Hct is above 60%, except when there are severe symptoms attributable to hyperviscosity. Normalization of Hct in these patients is not desirable because there is a need for extra oxygen-carrying capacity.[4]

An Hct >60% is associated with spontaneous clotting of blood. A Hgb value >20 g/dl leads to clogging of the capillaries as a result of hemoconcentration. Hence urgent management is needed for these patients once the critical level is reached.

References:
==========
1. Kwaan HC, Bongu A. The hyperviscosity syndromes. Semin Thromb Hemost 1999; 25: 199-208.
2. Kasper F, et al. Harrison’s Principles of Internal Medicine. 16th ed. New York: McGraw-Hill; 2005.
3. Wasserman LR, Balcerzak SP, Berk PD. et al. Influence of therapy on causes of death due to polycythemia vera. Trans Asso Am Physicians 1981; 94: 30-38.
4. Zarkovic M, Kwaan HC. Correction of hyperviscosity by apheresis. Semin Thromb Hemost. 2003 Oct;29(5):535-42.

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