Doctors Lounge - Hematology Answers
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Forum Name: Hematology Topics
Question: Elevated hematocrit
|msdi - Thu Jan 26, 2006 12:22 am|
My husband is 44 yrs old. He works in a lab for a aluminum company testing samples. He just recently had his physical at work and his hematocrit came back elevated. He does not smoke, drink or use any type of drugs. He is exposed to different types of dangerous chemicals each day. When he received the results he called the medical department. The nurse told him that the elevated hematocrit was nothing to worry about. But today the medical dept. called him and said that the doctor wanted to repeat the test again because of the elevation. The only meds he takes is Micardis HCT 80/12.5, Effexor XR 150 mgs, and Zeita all on a daily basis. Should we be concerned because of this test and because of his exposure to the chemicals. Thanks so much for your input.
|Dr. Tamer Fouad - Thu Jan 26, 2006 1:17 am|
As I mentioned in another post, 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.
The evaluation of polycythemia involves first the exclusion of relative polycythemia hemoconcentration that results from decreased plasma volume in conditions such as dehydration.
Secondary polycythemia can arise due to an appropriate bone marrow response to decreased tissue oxygenation, such as: high altitude, cardiopulmonary disorder and increased affinity for oxygen.
Secondary polycythemia with normal tissue oxygenation may result from benign renal lesions (renal artery stenosis, renal cysts, hydronephrosis, nephrocalcinosis, transplant rejection, etc.); neoplasms (renal, hepatic, ovarian, adrenal, cerebellar); endocrinopathies (Cushing's syndrome, pheochromocytoma).
Primary polycythemia or polycythemia vera is a myeloproliferative disorder in which the production of RBCs is not controlled by and is independent of erythropoietin. Besides an elevated hematocrit, patients with this disease also have leukocytosis, thrombocytosis, splenomegaly, and a hypercellular bone marrow with trilinear hyperplasia. In early stages, however, a high hematocrit may be the only manifestation.
In the absence of dehydration, a hematocrit greater than 60% is always associated with an increase of RBC mass and is diagnostic of polycythemia. For hematocrit values of 50% to 60%, the diagnosis of polycythemia requires direct measurement of the RBC mass. An RBC mass greater than 32 ml/kg in women and 35 ml/kg body weight in men confirms the diagnosis of polycythemia.
Once the diagnosis of true polycythemia is established, the major differential diagnosis centers between polycythemia vera and secondary polycythemia.
In your husbands condition it would important to know the hematocrit level? If all the other results came back normal or not? Does he have long-term exposure to benzene?
|msdi - Thu Jan 26, 2006 3:02 am|
Yes, Doctor I do believe that he has chronic exposure to Benzene, along with Haxane and several other chemcals. He has worked in the lab for going on 12 years. The hoods that are used in one part of the lab do not draw correctly and also in another part of the lab they are exposed to some type of fine black dust (it almost appears to be graphite because it is so fine and dark) this is also on a chronic basis. I will get the other chemicals he is exposed to on a daily basis and let you know what they are. They you for your help.
|msdi - Thu Jan 26, 2006 1:40 pm|
Doctor, some of the chemicals that my husband is exposed to on a daily basis is the following:
toulene, 1..4 dioxane, nitric acid, sulfuric acid, sodium hydroxide, hexane, pentane, isopropyl alcohol 99.9%, phosmobolic acid and aluminum dust
He is not exposed to benzene. Thanks for your help.
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