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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Blood Tests Done, Hemolytic Anaemia. Whats The Diagnosis, Is It Realted To Liver Disorder Or B12 Deficiency?

hey just wondering if you can make a diagnosis on th basis of these blood test results patient is in late 20 s female haemoglobin = 13.1g.dL (below normal) hematocrit = 35.2 % (below normal) RBC count = 3.1^6 (below normal) reticulocyte count 0.9 (normal) Unconjugated bilirubin 2.8 (above normal) LDH = 420U/L (above normal) B12 = 85ng/L (above normal) Folate = 11.5 (normal) just not sure on the diagnosis was thinking the pateint is suffering hemolytic anaemia but that doesnt explain the b12 deficiency or perhaps the patient has both? is this related to any disease or disorder? liver disease? or do more tests need to be done, if so what tests would you recommend to confirm a diagnosis? thank you! james
Thu, 27 Mar 2014
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General & Family Physician 's  Response
Hi,
We can not confirm that it is hemolytic anemia with a normal reticulocyte count. However, mild hemolysis can happen in the bone marrow itself in B12 defeciency (ineffective erythropoisis) and can elevate your bilirubin.
As your liver function tests are not done (or not posted), we can not rule out liver disease like Gilberts syndrome or Crigler Najar syndrome (normal SGOT/SGPT raises the possibility).
you may undergo bone marrow aspiration to look for the presence of large precursor cells which will add to the possibility of B12 defeciency. All the best
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Blood Tests Done, Hemolytic Anaemia. Whats The Diagnosis, Is It Realted To Liver Disorder Or B12 Deficiency?

Hi, We can not confirm that it is hemolytic anemia with a normal reticulocyte count. However, mild hemolysis can happen in the bone marrow itself in B12 defeciency (ineffective erythropoisis) and can elevate your bilirubin. As your liver function tests are not done (or not posted), we can not rule out liver disease like Gilberts syndrome or Crigler Najar syndrome (normal SGOT/SGPT raises the possibility). you may undergo bone marrow aspiration to look for the presence of large precursor cells which will add to the possibility of B12 defeciency. All the best