Published
One year s/p bariatric surgery. Hemoglobin 19 and Hematocrit 56 (high) all other indices completely normal. Folate 300 ng/mL. (very low) and Vitamin B12 180 (very low)!
Anyone else make sense of this? I'm personally redrawing everything in two months but I referred to hematology.
https://www.hindawi.com/journals/bmri/2013/205467/
Part 7. Copper deficiency and MGUS-like changes in bone marrow, can lead to high Hb till the iron stores run low.
58 minutes ago, KatieMI said:Relatively common, only one type of it. Polycytemia vera or MGUS going into this direction with prevalence 22-24/100000 (well, there are a few more, but they are closer to dinosaurs than to zebras). Overall, this is a possibility rare enough to worry about at the first stage of DDx. All very common "horses" (smoking, dehydration, etc) should be reliably excluded before specialty referral.
Actually I was referring secondary polycythemia due to EPO-secreting tumors, like RCC. Seen a few in the ER I picked up with a CT scan after abnormal CBC. But I agree the other more common causes of secondary polycythemia should be considered first.
KatieMI, BSN, MSN, RN
1 Article; 2,675 Posts
Relatively common, only one type of it. Polycytemia vera or MGUS going into this direction with prevalence 22-24/100000 (well, there are a few more, but they are closer to dinosaurs than to zebras). Overall, this is a possibility rare enough to worry about at the first stage of DDx. All very common "horses" (smoking, dehydration, etc) should be reliably excluded before specialty referral.