Help deciphering CBC results

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Help deciphering CBC results
« on: June 22, 2008, 09:18:33 PM »
Hi guys,

After one year I did another CBC (different lab and country I'll post the year old results in red and current results in black)

WBC 4 x 103 c/uL             5.2 thous/mcL
Hemoglobin 9.4g/dL                          12.2g/dL
RBC 3.7 x 106                   4 mill/mcL
Hematocrit 32%                               34.9%
MCV 86FL                                        87.2FL
MCH 26                                           30.4pg
MCHC 30 g/dL                                  34.9g/dL
Blood Smear
RBC  Hypochromia, Anisocytosis          RBC Moderate anisocytosis and Moderate Target cells       
        Poikilocytosis
Platelet count adequate in both cases

The hemoglobinopathy done last year showed (I had two pints of blood in March and this test was done in June - should have been all my blood I think)
Hg A @ 55.9%
Hg F @ 6.2%
Hg C @ 35.3%
Hg A2 @ 2.6%

Doctor last year told me I have nothing to worry about but at times the veins/arteries in the palm of my hand are clearly visible...today I can only see the major one. My new doctor thinks i look jaundiced so he had a liver function and kidney function test done. They look okay my BUN is on the really low side of normal and the BUN:cretinine is 7:1 I believe. This doctor is very enthusiastic so hopefully he's good.

Thanks guys
« Last Edit: June 22, 2008, 09:27:30 PM by Sash »

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Offline Andy Battaglia

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Re: Help deciphering CBC results
« Reply #1 on: June 23, 2008, 02:34:09 AM »
Hi Sash,

Did your doctor discuss your hemoglobin readings with you? Apparently, in addition to being a beta thal carrier, you also carry the hemoglobin C gene. In fact, there is no way possible for you to not be an HbC carrier because only HbC carriers will have any HbC in their blood. Your other results are mostly consistent with beta thal trait, although the MCV is high and HbA2 is low for a minor. DNA testing would verify if you are a beta thal carrier. Because of the co-existence of the HbC, DNA testing may be the only way to determine exactly what mutations you have.

This combination would explain much about your health, as the combination causes a worse anemia than beta thal minor will cause by itself. This was discovered long ago but is not common knowledge, since HbC is not as commonly seen as beta thal. A study of a patient and his siblings in 1954 established that this combination caused a worse anemia and more symptoms than the same beta thal gene by itself, did in his siblings.

http://bloodjournal.hematologylibrary.org/cgi/reprint/9/11/1047.pdf

Quote
From the observations available thus far’ ‘ 6 . 7 it appears that the uncomplicated
hemoglobin C trait (A-C) produces an asymptomatic carrier state such
as was found in the father of our patient, and manifest only in the frequency of
target cells in the 1)lood. It is clear, therefore, that the C gene alone cannot be
responsible for the striking blood picture observed in the patient, even though
his hemoglobin proved to be the combination A-C. The evidence indicates that
ill addition to the hemoglobin C trait this child harbors the thalassemia gene
and that the imiteraction of these traits-which singly are relatively benign-has
produced a new amid severe type of anemia.

It is well established that one can expect a more severe anemia with Hb beta thal HbC.
From http://journals.elsevierhealth.com/periodicals/ymai/medline/record/MDLN.8442646

Quote
Eleven cases of simultaneous HbC hemoglobinopathy and beta-thalassemia were detected during a study of 11,200 subjects at high risk for inherited hemoglobin anomalies. In seven cases, main clinical manifestations were anemia and enlargement of the spleen, whereas the four other patients were apparently free of symptoms and were diagnosed during routine tests in family members of affected patients. Microcytosis and hypochromia were found in every case. Most of the patients were from the North-Western part of Tunisia. Blood transfusions were required in only one patient, who was an infant with HbC/beta + thalassemia.

Generally, it has been found that HbC beta thalassemia results in a more severe anemia than thal minor causes on its own. Enlargement of the spleen is often observed. The biggest concern in HbC beta thal is for pregnant women, as a potentially life-threatening situation can arise during pregnancy. This has previously been discussed as a possibility in Courtenay's case at http://www.thalassemiapatientsandfriends.com/index.php?topic=549.msg4100#msg4100

Continuing your program of good nutrition is perhaps the best thing you can do for yourself. Common sense health habits like always washing your hands and avoiding sick people can help you avoid infections. Avoiding high physical stress can also help, as you have seen with dehydration.
Andy

All we are saying is give thals a chance.

 

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