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Old Sat Sep 3, 2016, 04:20 PM
zent1000 zent1000 is offline
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Join Date: Sep 2016
Posts: 11
Question About My Father's Abnormal MCV, MCH and RBC

Hello,

Thank you for your time!

This is a question regarding my father. He is 79 years old. Every three months, he gets routine blood tests done by his Primary Care Physician(PCP). He has been having slightly elevated MCV values (around 98) for 3 years and the last MCV on May 5, 2016 was 102.26.

He saw a Hematologist on May 15, 2016 and a follow-up visit on June 18, 2016 (details of the visit are mentioned after the next paragraph).

Following is a listing of his values for MCV, MCH, RBC and Hemoglobin for the last eight test periods. His values for WBC and Platelets have been normal for all the tests:

MCV - (Reference Range : 80-96) measured with PCP
Dec 2013 : 98.2
March 2014 : 98.6
June 2014 : 98
Feb 2015 : (Less than 100)
Feb 2016 : 101.94
May 5,2016 : 102.26

MCV - (Reference Range : 80-98) measured with Hematologist (different lab)
May 15,2016 : 98.3
June 18, 2016 : 97.6


MCH - (Reference Range : 27-31) measured with PCP
Dec 2013 : 33.7
March 2014 : 33.6
June 2014 : 34.7
Feb 2015 : (Don't have the value : possibly around 34)
Feb 2016 : 34.4
May 5,2016 : 33.58

MCH - measured with Hematologist (different lab)
(Reference Range : 26-34)
May 15, 2016 : (Don't have the value handy but it was less than 34)
June 18, 2016 : 33.8


RBC - (Reference Range : 4.5 to 6.2)
Dec 2013 : 4.42
March 2014 : 4.32
June 2014 : 4.5
Feb 2015 : (Don't have the value : possibly around 4.5)
Feb 2016 : 4.37
May 5, 2016 : 4.65

RBC- measured with Hematologist (different lab)
(Reference Range : 4.5 - 6.5)
May 15, 2016 : (Don't have the value handy but it was slightly more than 4.5)
June 18, 2016 : 4.55

Hemoglobin- (Reference Range : 14-18)
Dec 2013 : 14.9
March 2014 : 14.5
June 2014 : 15.6
Feb 2015 : (Don't have the value but it was normal)
Feb 2016 : 15.05
May 5, 2016 : 15.74

Hemoglobin- measured with Hematologist (different lab)
(Reference Range : 13.5 - 18)
May 15, 2016 : 15.5
June 18, 2016 : 15.4


During my father's last visit with his PCP in Feb 2016, his PCP told him that he has Vitamin B12 deficiency and he was prescribed the following:

OPTINEURON INJECTIONS (Vitamin B1 + B12 + B2 + B3 + B5 and B6)

Alternate Days (for one week)
Twice a week (4 weeks)
Once a month (1 year)


During his first visit to the Hematologist on May 15, 2016, my father was given the following report:
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Patient does not show any abnormal cells. Physical examination is within normal limits.

The patient has a normal CBC. Also, probably a normal MCV after taking Vitamin injections.However Vit B12 deficiency is usually associated with Pancytopenia and a higher MCV.

Therefore we will see the patient and repeat CBC on June 18, 2016. If there is rise in MCV again, then we should rule out Myelodysplastac syndrome (MVS) and also perform a thyroid test and I agree with continuing OPTINEURON injections once a month for six more months

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The thyroid test (T3, T4 and TSH) for my father was done in the second week of June 2016 and was normal. My father followed-up with the Hematalogist on June 18, 2016. After that visit, I spoke to the Hematologist by phone. He told me that even after taking Vitamin B12 injections for some months now, my father's MCV (97.6) and Hemoglobin (15.4) have not responded as well as it should have even though they are within normal limits. Given that my father is 79, the Hematologist told me that my father probably has MDS and advised us to get a bone marrow biopsy in July 2016 for confirmation. We have postponed the biopsy for September 2016 as he had a throat infection for almost a month and also had pain in his knee/hips from which he as not fully recovered yet. He is otherwise fine without any other symptoms.

My father is a vegetarian and has never consumed any alcohol all his life. He has been taking the "Calcium Citrate Malate Vitamin D3 and Folic Acid Tablet Supplement" once per day for over 7 years. His diet is brown rice, wheat bread, fruits, nuts and vegetables. He is 5 ft 3 inches in height and weighs 119 lbs with a waist size of 35 inches.


Questions:
1) Given this background (I realize its limited), what do you think are the chances of my father having MDS?

2)
During his CBC on May 5, 2016, his WBC Differential Count had the following abnormal values:
a) Eosinophils (7.9, Ref Range: 1-6)
b) Basophils (1.1, Ref Range : 0-1)

On his CBC on June 18, the WBC Differential Count had abnormal values for Monocyte (01, Ref Range - 2 to 8 %) and all other values were normal.

Any concerns?


Thank you!!
Zent

Last edited by zent1000 : Sat Sep 3, 2016 at 05:15 PM.
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