Normal Rbc Count But Low Hemoglobin And Hematocrit – Hematocrit (HCT) refers to the percentage of red blood cells (RBC) in a person’s blood. Adults with XY chromosomes typically have an HCT between 40% and 54%, and adults with XX chromosomes have an HCT between 36% and 48%. In addition to red blood cells, blood has three main components: white blood cells, platelets, and plasma.

Hematocrit measures the percentage of red blood cells in the total blood volume. A hematocrit test can be done using a capillary tube and a centrifuge machine (ie, a machine that uses centrifugal force to separate substances in the blood because of their different densities). Hematocrit levels are usually determined as part of a complete blood count (CBC), but can also be tested alone. However, the CBC is the most common blood test that measures the HCT while also measuring the red blood cell count, white blood cell count, hemoglobin level, and platelet count.

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Hematocrit is a very useful laboratory result because too few or too many RBCs can be a clinical indication of various conditions such as anemia or polycythemia. It can also be used to monitor individuals post-surgery to prevent or screen for complications such as internal bleeding.

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A low hematocrit, also known as anemia, can be the result of decreased production of red blood cells, increased blood loss, increased destruction of red blood cells, or a combination of these.

The most common cause of a low hematocrit is chronic (eg, ulcers, colon cancer) or acute (eg, trauma, internal bleeding) bleeding that causes significant blood loss. Individuals of reproductive age who are female at birth may have a low hematocrit due to menstruation. However, the hematocrit may also decrease due to peripheral destruction of red blood cells, which is seen in conditions such as sickle cell anemia, where red blood cells have a shorter life span; and splenomegaly (ie, enlargement of the spleen), where large numbers of healthy RBCs are destroyed in the spleen. Another cause of a low hematocrit is decreased red blood cell production, seen in chronic inflammatory diseases, or bone marrow suppression caused by radiation therapy, malignancy, or drugs such as chemotherapy. Finally, malnutrition (eg, iron, B12, and folate deficiencies) and overhydration can also cause a decrease in hematocrit.

Dehydration due to fluid loss from repeated vomiting, overheating, or limited access to fluids can lead to hemoconcentration. In addition, low oxygen availability triggers the production of new blood cells to transport oxygen throughout the body and can be caused by smoking; high altitudes; congenital heart disease; or certain lung diseases, such as pulmonary fibrosis or chronic obstructive pulmonary disease (COPD). In addition, polycythemia vera, characterized by an overproduction of red blood cells as a result of increased stimulation of the bone marrow (ie, myeloproliferation), can cause a high hematocrit. Similarly, increased erythropoietin production due to androgen use or erythropoietin production by kidney, liver, and ovarian tumors may also increase hematocrit. Finally, various endocrine pathologies, such as Cushing’s syndrome, can also cause high hematocrit levels.

Hematocrit measures the percentage of red blood cells in the total blood volume. The hematocrit test can detect various diseases and especially blood diseases. A low hematocrit, also known as anemia, can be the result of reduced red blood cell production, increased blood loss, increased destruction of red blood cells, or a combination of the above. On the other hand, a high hematocrit can be a result of hemoconcentration or overproduction of red blood cells, which can be triggered by various factors.

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Dixon, L.R. (1997). Complete blood count: physiological basis and clinical use. The Journal of Perinatal & Neonatal Nursing, 11(3), 1–18. DOI: 10.1097/00005237-199712000-00003

Kragh-Hansen, U. (2018). Potential mechanisms by which enzymatic degradation of human serum albumin may lead to bioactive peptides and biomarkers. Frontiers in Molecular Biosciences, 5: 63. DOI: 10.3389/fmolb.2018.00063 Polycythemia (also known as polycythemia) is a laboratory finding in which the hematocrit (percentage of red blood cells in the blood) and/or hemoglobin are elevated in the blood. Polycythemia is sometimes called erythrocytosis, and the two findings overlap considerably, but the terms are not the same: polycythemia describes an increase in hematocrit and/or hemoglobin, while erythrocytosis describes an increase in the number of red blood cells in the blood. blood.

Absolute polycythemia can be caused by bone marrow mutations (“primary polycythemia”), physiological adaptations to the human virus, medications, and/or other medical conditions.

Laboratory tests, such as serum erythropoietin levels and genetic tests, may be helpful in clarifying the cause of polycythemia if the physical examination and medical history do not indicate a likely cause.

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Mild polycythemia itself is often asymptomatic. Treatment for polycythemia varies and usually involves treating the underlying cause.

Treatment for primary polycythemia (see polycythemia vera) may include phlebotomy, antiplatelet therapy to reduce the risk of blood clots, and additional cytoreductive therapy to reduce the number of red blood cells produced in the bone marrow.

Polycythemia is defined as a serum hematocrit (Hct) or hemoglobin (HgB) above the normal range expected for age and sex, usually Hct > 49% in healthy adults m and >48% in women or HgB > 16.5 g/dL m or > 16 .0 g/dL in a woman.

In adults, polycythemia can be caused by various diseases or conditions. These processes are discussed in more detail below in their respective sections.

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Relative polycythemia is not a true increase in the number of red blood cells or hemoglobin in the blood, but rather elevated laboratory findings caused by a decrease in blood plasma (hypovolemia, cf. dehydration). Relative polycythemia is often caused by loss of body fluids, such as from burns, dehydration, and stress.

A specific type of relative polycythemia is Gaisböck’s syndrome. In this syndrome, which occurs primarily in obese individuals, hypertension causes a decrease in plasma volume, resulting in (among other things) a relative increase in the number of red blood cells.

If relative polycythemia is considered unlikely because the patient has no other signs of hemoconcentration and has persistent polycythemia without obvious loss of body fluids, the patient probably has absolute or true polycythemia.

Neonatal polycythemia is defined as hematocrit > 65%. Significant polycythemia can be associated with blood hyperviscosity, or thickening of the blood. Causes of polycythemia in newborns include:

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The pathophysiology of polycythemia varies depending on its cause. The production of red blood cells (or erythropoiesis) in the body is regulated by erythropoietin, which is a protein produced by the kidneys in response to poor oxygen supply.

As a result, more erythropoietin is produced to encourage red blood cell production and increase oxygen-carrying capacity. This results in secondary polycythemia, which may be an appropriate response to hypoxic conditions such as chronic smoking, obstructive sleep apnea, and high altitude.

In addition, certain geologic conditions can impair the body’s accurate detection of oxygen levels in serum, leading to excessive erythropoietin production without hypoxia or impaired oxygen transport to tissues.

Alternatively, certain types of cancer, particularly squamous cell carcinoma, and medications such as testosterone use can cause inappropriate production of erythropoietin, which stimulates red blood cell production despite an adequate oxygen supply.

Hemoglobin And Hematocrit

Primary polycythemia, on the other hand, is caused by mutations or defects in erythrocyte progitors in the bone marrow that cause excessive growth and hyperproliferation of red blood cells regardless of erythropoietin levels.

An increased hematocrit and red blood cell mass with polycythemia increases the viscosity of the blood, which causes impaired blood flow and increases the risk of clotting (thrombosis).

The first step in evaluating any individual for new polycythemia is to perform a detailed history and physical examination.

Patients should be questioned about smoking history, height, medication use, personal bleeding and clotting history, symptoms of sleep apnea (snoring, apnea episodes), and family history of hematologic conditions or polycythemia. A thorough cardiopulmonary examination, including auscultation of the heart and lungs, can help evaluate for cardiac shunting or chronic lung disease. Abdominal examination can evaluate for splomegaly, which may be detected in polycythemia vera. Examination of the digits for erythromelalgia, clubbing, or cyanosis may help assess for chronic hypoxia.

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Polycythemia is often diagnosed by a complete blood count (CBC). A CBC is often repeated to evaluate for persistent polycythemia.

Primary polycythemias are myeloproliferative diseases that affect red blood cell precursors in the bone marrow. Polycythemia vera (PCV) (also called polycythemia rubra vera (PRV)) occurs when excess red blood cells are produced due to abnormalities in the bone marrow.

Excess white blood cells and platelets are also often produced. Polycythemia vera is characterized by an elevated hematocrit with Hct > 55% in 83% of cases.

A somatic (non-inherited) mutation (V617F) in JAK2 ge, which also occurs in other myeloproliferative disorders, is found in 95% of cases.

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Symptoms include headaches and dizziness, and physical examination findings include an abnormally large spleen and/or liver. In some cases, affected individuals may have associated conditions, including high blood pressure or blood clots. Transition to acute leukemia is rare. Phlebotomy is the mainstay of treatment.

Primary familial polycythemia, also known as primary familial and congenital polycythemia (PFCP), exists as a highly inherited condition, unlike the myeloproliferative changes associated with acquired PCV. In many families, PFCP is due to an autosomal dominant mutation in the EPOR erythropoietin receptor gene.

PFCP can cause up to a 50% increase

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