Hematology Case Studies A 62yearold male complained of weakn

Hematology Case Studies

A 62-year-old male complained of weakness, headache, lightheadedness, and fatigue. Upon physical examination, the following information was available: Erythrocytes 8.5 million/cu mm Leukocytes 12,500/cu mm Thrombocytes 400,000/cu mm Hct 58% O2 saturation (arterial) 94% Serum erythropoietin Undetectable Other information: The erythrocytes and leukocytes were immature in the peripheral blood smear. The spleen was enlarged. The determined therapy of choice was phlebotomy, 300-500 mL every other day, until the hematocrit was <45% with the possibility of myelosuppressive therapy, if needed.

Define phlebotomy and How does phlebotomy help correct this problem?

Solution

From the diagnosis it is clear that the patient is suffering from polycythemia. It is a condition in which the red blood cells are more in the blood. The value of hematocrit for a male in this condition is above 52%. The possible treatment available is phlebotomy. It is a process of blood removal or blood letting to maintain the level of hematocrit. Regular withdrawal of 250-500 ml blood is prescribed based on the condition.

After phlebotomy, the bone marrow is triggered to produce new RBC. To synthesize new RBC, iron molecule is required. The ferreting available in the system is utilized for this mechanism. This reduces the overall iron content in the blood I.e. all the iron are associated with hemoglobin. The serum ferritin drops to 30 ng/ml for every unit of blood removed. The procedure balances the RBC value in blood.