Hematology ?

December 3, 2005

Please help me " sort out " abnormalities in 's labs. Every search I've

tried links me back to Thalessemia but nothing quite " fits " .

Hx: was diagnosed with Thalessemia B minor around the age of 4 and

treated for a number of years (until her values were stable). She, also, has a

diagnosis of Plasminogen Activator Inhibitor Deficiency. Over the past several

months her CBC has been doing odd things, ie RBC drops to around 3.5 and MCH

elevations with low RDW. Hematoilogy keeps saying she's NOT anemia as her H &

H are ok. THey also have stated repeated she doesn't heve/didn't have

Thalessemia B minor (even though no labs were ever done other than the initial

diagnostic ones) and her rion levels, etc are all fine (again, they never

redraw them ,just seemed to assume). I asked our case managing physician to do

some basic labs to recheck since one group insists things are fine, yet

looks pale, is more tired, etc. (and he agreed).

Labs: Hemoglobin A high 97.9 (94.1-97.7%), Hemoglobin F 0.2 (0-2.0%),

Hemoglobin A2 low 1.9 (2.3-3.9%). TIBC high 492 (294-434), Vit B 12 high

(200-1100), Ferratin 10.6 (10-70), Iron 81 (44-142), Retic 1.2 (0.5-2.2%).

Her Lactate was 17 high (4-15) and Pyruvate 1.42 high (0.3-0.7), Ammonia 20

(normal) . Amino acids and organic acids pending.

Bill Rhead siad the metabolic labs are " off " and maybe we need to look at

adding Mg (Dr. Whiteman said no previously as her MG level is high end of

normal). No one seems concerned about the hematology labs yet given her RBC is

bouncing between very low normal and low, I can't help but wonder why?

Dr. Rice (case managing doc) is open to my opinions/thoughts, especially if

I can support those ideas with journal articles etc. Do you have any idea

what these values might indicate???

Joanne Kocourek (mom to , lies, and )

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