Question

Anemia Case Study

A routine admission CBC was analyzed on a 55 year old white female using an automated cell counter. The results were:

WBC:              4,500/ul

RBC:              3.2 x 10⁶/ul

Hb:                  14.2 g/dl

Hct:                 36.0%

MCV:              112.5fl

MCHC:           39.4 g/dl

1. Do the hemoglobin and hematocrit values match in this case? Explain your    answer.

2. Are all of the red cell indices above the usual reference range?
3. Do these abnormal results represent a laboratory error or a blood disorder? Why?
4. What can be done to verify accurate results for this patient?
5. What is the diagnosis for this patient based on these results?

Answer 1

1. Hematocrit value is not matching with Hemoglobin value. The stsndarf calculation of Hematocrit is 3 times of hemoglobin value. Here hemoglobin value is falsely high. The CBC counts says that the patient is suffering from Macrocytic anemia as ebident from MCV and MCHC values. Hemoglobin is expected to be low. but it is in high range.

2. Not all red cell indices is high except for MCV and MCHC.

RBCs , hematocrit is low.

3. Hemoglobin value might be laboratory error. Decreased RBCs , Increased MCV, MCHC indicates macrocytic anemia.

4. Vitamin B12 serum test & Methylmalanoic acid test is recommended, Serum folate test to be done.

5. Macrocytic Anemia