Why does pernicious anemic patients have increased hematocrit level?

[by_stander22, LPN]

When in fact they have decreased RBC count. I passed by on this rationale of one of the books and confusion struck me. THANK YOU!

[EricJRN, MSN, RN]

Usually they don't have increased Hct.

[pinkiepie_RN]

well, i think it's because of the size of the blood cells themselves. pernicious anemia is also known as macrocytic anemia and i think the blood cells are larger than normal in an attempt to make up for their decreased ability to carry oxygen, but correct me if i'm wrong.

i also discovered a quote from emedicine which might help:

"anemia: the anemia often is well tolerated in pernicious anemia, and many patients are ambulatory with hematocrit levels in the mid teens. however, the cardiac output is usually increased with hematocrits less than 20%, and the heart rate accelerates. congestive heart failure and coronary insufficiency can occur, most particularly in patients with preexisting heart disease (conrad & aboulafia, 2006)." - http://www.emedicine.com/med/topic1799.htm

"the number of red blood cells. too few red blood cells means a person has anemia. a low number of red blood cells is usually seen with either a low hemoglobin or a low hematocrit level, or both." - http://www.nhlbi.nih.gov/health/dci/diseases/prnanmia/prnanmia_all.html

that's about all my brain can think of right now as it is still early in the am on summer break.

[Daytonite, BSN, RN]

keep in mind that the hematocrit is a measure of the percentage of the total blood volume that is made up of rbcs or how much space the rbcs take up of the blood volume. abnormalities in rbc size can alter the outcome of the test. in pernicious anemia (macrocytic anemia) the rbcs are oversized so it is possible to have a small number of jumbo sized rbcs causing a low rbc count and a high hematocrit.

http://www.nutrihand.com/healthcenter/medical/archive/pernicious%20anemia.html