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What Do These Blood Reports Indicate?

Posted on Mon, 2 Nov 2015

Question: I had some blood work done back in March that showed elevated Hemoglobin and Hematocrit levels. Last month, I retook the test, and this time it showed elevated Hemoglobin, Hematocrit, Red Blood Cells, White Blood cells, and Neutrophils, Absolute. I had also been experiencing sternum pain for the past few months. I went to the doctor, and he advised that there is an autoimmune disease called Sarcoidosis he would like to rule out, and that I would need to get a chest x-ray. So, I went to get the chest x-ray and the radiologist asked what I was there for. I told him about the sternum pain, and abnormal labs, and the condition my doctor wanted to rule out. However, the radiologist only took a picture of the left side of my chest, and the side, and the report only says that osseuous structures appear intact without evidence of fracture. I knew this wasn't a fracture, and I don't think this is the information my doctor was looking for. I think my doc was looking for more of a full chest x ray and to see lymph nodes, etc.. Can you please look at the x-ray? Can you see any swollen lymph nodes or any other things besides the bone structure might be suspicious?

Answered by Dr. Deepak Sundriyal (16 minutes later)

Brief Answer:
You require proper x-ray

Detailed Answer:
hello dear.

I have gone though your details. In fact , i require
1. your reports of complete blood counts.
2. Also you require a proper XRAY as it is only the lateral view which is not giving good amount of information.
Please get an PA view of chest XRAY done and revert back with reports.
Nodes are not visible in this view.

let me make it also clear that sarcoidosis does not present with elevated counts. There are some suggestions which I can make only after seeing the reports.
Thanks and regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Deepak Sundriyal (38 minutes later)

Thank you for your response. I have attached the blood labs from March 25, 2015 as well as September 14, 2015. Please let me know your thoughts.

Answered by Dr. Deepak Sundriyal (12 minutes later)

Brief Answer:
Hello. You require tests.

Detailed Answer:
Hello. I have gone through the details.
So you are a diabetic.
Initial reports of march shows a mildly increased hemoglobin (otherwise we take upto 16 as normal hemoglobin), rest all counts we take normal(borderline increased and thus no significance).
You also had increased AST and ALT which is most likely a part n parcel of metabolic liver disease(steatohepatitis due to diabetes), as your viral marker panel for hepatitis and auto immune hepatitis screen is normal.
Only point of concern is mildly increased hemoglobin which can be raised in conditions like
1.lung illnesses
2.smokers
I think you fall in neither of the categories. So again will take your hemoglobin as normal(as i mentioned we take 16 as upper limit).
You just need a management of diabetes.
For chest pain i would suggest a cardiac workup including ECG, ECHO and treadmill if required. Also an XRAY As i advised
Thanks
Revert back for more issues. Take care

Above answer was peer-reviewed by : Dr. Neel Kudchadkar