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Forum Name: Hematology Topics

Question: Low Platelets, wbc, rbc


 30jewel - Fri Jul 16, 2010 11:42 am

Hi, I've had low platelets low rbc and low wbc for 2 years. I've been seeing the same heatologist for a year. Last blood work done 7/8
wbc-3.0
rbc-3.71
hgb13.5
hct 36.7
mcv 99.1
mch 36.5
plt 80

the range for my blood eork over the last year is as follows
aug Sep Nov Dec Feb Mar Apr May Jul
wbc 3.7 2.8 2.3 2.5 2.5 2.7 3.1 3.1 3
rbc 3.87 3.86 4.13 4.03 4.11 4.05 4.13 3.98 3.71
HGB 14.4 14.1 14.5 14.5 14.5 14.4 14.7 14.1 13.5
HCT 39.3 38.6 41.3 40 40.5 39.6 40.2 39.1 36.7
mcv 101 100 100 99.3 98.4 97.8 97.5 98.1 99.1
plt 75 84 86 78 85 90 86 87 80
mch 37.2 36.6 35.2 36.8 35.2 35.6 35.6 35.5 36.5
b12 966

I had a bone marrow test done in august 2009 and april 2010
april bone marrow showed - 30-60% cellularity with erthroid predominance with increased prormblasts,mild dyserythropoiesis,mycloid andd erthroid maturation present megakarocytes low normal in number with unremarlable morphology, one small lymphoid aggregate predominanthy small cells, mild increase in interstital mast cells and increased iron stores.

I stopped drinking all alcohol in august 2009 concerned that that may be an issue, my question is if i screwed up my bone marrow from drinking too much could it take this long to recover?

I had a mri done for lower back pain which showed- the marrow signal isdiffusely heterogeneous with numerous areas of low signal abnoramlity throughout the lumbar spine in s1-s2 and in the left iliac bone adjacent to the si joint. A CT scan was also done which showed scattered mottled areas of lucency in the same area. no lymphadenopathy or splenomegaly. The lower back pain went away - i have had back issues for years on and off and my appointment with my hemotogist was on a day that it was really bad and he offered to schedule the mri which started this ct scan and then the second bone marrow to rule out NHL. My question on this is can alcohol cause these areas on the mri/ct scans in the spine and be the root cause of the problem?

I am male, 53, have no symptoms, the low blood counts surfaced in oct 2008 as result of a doctors visit.
 Dr.M.Aroon kamath - Thu Jul 22, 2010 2:48 am

User avatar Hi,
Bone marrow involvement in alcohol misuse/abuse can happen in the following scenarios:
- as "bone marrow failure" or
- as "intraosseous fat necrosis" associated with alcoholic pancreatitis.


Cases of severe pancytopenia with bone marrow hypoplasia after consuming excessive amounts of alcohol for many years have been reported.Prompt hematologic remissions have also been noted in these individuals if they completely abstained from alcohol and consumed an adequate diet.

Bone marrow failure may manifest as failure of the marrow to produce 1, 2, or all 3 cell lines of the blood (Single cytopenias, bicytopenias, and Pancytopenias respectively).

Bone marrow failure occurs more commonly in countries in the East than in the West(as In Japan & the Far East -at least 3 times higher than in the United States or Europe).Mexico and Latin America also show a high prevalence.

Cases of "intraosseous fat necrosis" associated with severe alcoholic pancreatitis also have been reported.Skeletal involvement may occur as an isolated phenomenon or simultaneously with subcutaneous nodules and polyarthritis in these individuals.

Some necropsy studies indicate a relatively higher prevalence (approximately 10%) of intramedullary fat necrosis in patients who died of acute pancreatitis.

Thankfully you have suffered a milder form of what appears to be a pancytopenia with a relatively more prominent involvement of platelets. As i indicated earlier, studies show "prompt" recovery to near-normal levels of the blood elements provided.....
- alcohol intake is completely stopped,
- person consumes an adequate diet and
- no other contributing/aggravating factor exists.

Hope you will recover soon,
Good luck!

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