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Forum Name: Hematology Topics

Question: low blood crit


 Tiger - Sun Sep 25, 2005 11:42 am

I am a female, 47yrs. old. I recently was diagnosed with anemia. My blood crit was at 23 when my doctor did blood work. He said I was close to needing a transfusion. He put me on 3 iron tablets a day. After more blood work, he lowered it to 2 a day. I have Ulcerative colitis & went in for a colonoscopy & an endoscopy. I was told I had a hernia but no bleeding was found from the colitis. I still have a low blood count and was told I might need to take iron shots. I have had blood transfusions in the past (due to bleeding from the colitis) but I am concrned about the low iron count since my doctor doesn't think it is from the colitis. Any input on this would be helpful. Thanks.
 Dr. Safaa Mahmoud - Wed Jul 26, 2006 1:51 pm

User avatar Dear Tiger,

The diagnosis of anemia is primarily made by the finding of low the hemoglobin level, RBC number , and the hematocrit. However, for the identification of the cause, many other parameters should be investigated.

The average volume (MCV) of the red blood cells is used to classify types of anemia. The normal MCV is in the range of (82-98) fl; values above and below this range indicate macrocytic and microcytic anemia, respectively.

The reticulocyte count is very important to determine the need for bone marrow examination; normal or elevated reticulocytic counts indicate adequate Bone marrow function and extrinsic cause for the anemia.

The hematocrit is almost about three times the measured hemoglobin value.

Macrocytic anemia are commonly due to B12 and folic acid deficiency.
While causes of normocytic anemia include: hemolytic anemia of various causes; aplastic anemia.
The microcytic anemia are usually due to deficient hemoglobin synthesis in cases of iron deficiency anemia and the anemia of chronic disease.

In iron deficiency anemia which represents the most common form of anemia, serum iron, iron-binding capacity, and ferritin; in addition to examination of the peripheral blood smear should be measured.

In patients with ulcerative colitis, anemia is usually due to iron deficiency anemia as a result of blood loss. Blood loss can be microscopic and detected only by microscopic examination of the stools.

Another possibility is the anemia of chronic inflammatory disease, in which there is a failure of iron incorporation in the developing erythrocytes.

Rarely in patients with ulcerative colitis, there is an associated autoimmune hemolytic anemia. The condition is confirmed by blood tests to detect increased amounts of antibodies (direct and indirect Coombs test).

Low ferritin level are commonly seen in:
Condition of chronic blood loss such as:
Inadequate iron intake.
GI bleeding from ulcers, colon polyps, colon cancer, hemorrhoids, etc.

IV (intravenous) infusion of supplemental iron is indicated when:
Oral intake is not convenient.
Higher doses of iron are needed in cases of severe anemia.
Inadequate absorption like in malabsorption
Rapid elevation of iron level is mandatory.

So, I hope you can inform us about the detailed results of your blood tests including the blood smear and the results of any other investigations that have been done recently.

Best regards,

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