WBC = normal with a normal differential and platelet count Hct = 29%; MCV = norm

Question

WBC = normal with a normal differential and platelet count Hct = 29%; MCV = normal, MCHC = slightly decreased; RDW = markedly increased; reticulocyte count < 2% Smear with mixed microcytic/hypochromic and macrocytic/normochromic red blood cells; WBC and platelets appear normal PT/PTT, liver function tests, electrolytes, and amylase normal Upper endoscopy with 2 cm. duodenal ulcer with evidence of recent but no acute hemorrhage ADDITIONAL LABORATORY RESULTS: Serum iron, total iron binding capacity, saturation, and ferritin all reduced Bone marrow biopsy with megaloblastic changes and low iron stores Serum folate and red blood cell folate low; B12 normal

What might the hematologic findings indicate and what should be done to further evaluate them?

Explanation / Answer

WBC: normal means there is no infection. Generally there is low or high count if infection is there. Hct low means there is loss of RBC somewhere due to ulceration. Corpuscular ranged are low due to loss of blood somewhere.

Thumb rule is whenever there is loss of blood it ultimately affect the RBC, hct, mchc and other blood related count.

Dudonal ulcer found but for more confirmation you must go for ultrasound and computerised tomography, if in that no evidence found then there is last of option of MRI for 100% confirmation.

Stools examination also performed for blood loss.

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