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What Causes Low Hemoglobin Count Even After Blood Transfusion?

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Posted on Thu, 9 Apr 2015
Question: My husband has had a hemaglobin level of 3.2 was hospitalized and given 9 bags of blood..raised it to a 9.2 had a scope and found 2 ulcers that were white coated doctor said the white is like a scab on them..told he was anemic and low iron...he was released with iron pills and stomach meds...1 week later blood test showed hemaglobin was at 8.2 ..hospitalized again..level dropped to 7.3 next day so given another bag of blood..liver biopsy was done showed he had XXXXXXX ...amonia level was 167...given meds to lower it to 67 then released again with meds...now 2 weeks later new blood work shows hemaglobin level at 8.2 ..low red and white cell counts 3.5 and 3.6...what could be causing this?..should we find a specialist to get a second opinion? ..we are at our wits end...what do you suggest ?
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Answered by Dr. Monish De (3 hours later)
Brief Answer:
Could be Myelodysplastic Syndrome

Detailed Answer:
Hi

Since your husband's haemoglobin is decreasing even after blood transfusion and his red and white cell counts are also low and scope found 2 ulcers and liver biopsy showed nonalcoholic steatohepatitis (NASH) he could be suffering from Myelodysplastic Syndromes(MDS).

It is a type of bone marrow disorders in which the bone marrow does not produce enough healthy blood cells.

Healthy bone marrow produces immature blood cells called stem cells, progenitor cells, or blasts that normally develop into mature, fully functional red blood cells, white blood cells, and platelets.

In MDS, these stem cells may not mature and may accumulate in the bone marrow or they may have a shortened life span, resulting in fewer than normal mature blood cells in the circulation.

This type of bone marrow failure syndrome will slowly progress to acute myeloid leukemia (AML) if not treated early.

I will advise your husband to do a bone marrow biopsy and aspiration test to find the exact cause of his low blood counts.

He needs to be treated with growth factor medications such as darbepoetin alfa.

I will advise you to consult a Haemato Oncologist.

Regards

DR DE




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Above answer was peer-reviewed by : Dr. Shanthi.E
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Answered by
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Dr. Monish De

Oncologist

Practicing since :2004

Answered : 2229 Questions

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What Causes Low Hemoglobin Count Even After Blood Transfusion?

Brief Answer: Could be Myelodysplastic Syndrome Detailed Answer: Hi Since your husband's haemoglobin is decreasing even after blood transfusion and his red and white cell counts are also low and scope found 2 ulcers and liver biopsy showed nonalcoholic steatohepatitis (NASH) he could be suffering from Myelodysplastic Syndromes(MDS). It is a type of bone marrow disorders in which the bone marrow does not produce enough healthy blood cells. Healthy bone marrow produces immature blood cells called stem cells, progenitor cells, or blasts that normally develop into mature, fully functional red blood cells, white blood cells, and platelets. In MDS, these stem cells may not mature and may accumulate in the bone marrow or they may have a shortened life span, resulting in fewer than normal mature blood cells in the circulation. This type of bone marrow failure syndrome will slowly progress to acute myeloid leukemia (AML) if not treated early. I will advise your husband to do a bone marrow biopsy and aspiration test to find the exact cause of his low blood counts. He needs to be treated with growth factor medications such as darbepoetin alfa. I will advise you to consult a Haemato Oncologist. Regards DR DE