need some help

[nobodth]

Hello

I'm sorry for my English skill which isn't very good.

I took a blood test 10 days ago that indicated that I had a very high hemoglobin (19.3). My doctor asked me to retake a blood test today to see if it could change. We also watched my old blood tests (2015 I was at 17.9 and in 2018 17.7). I am currently 20 years old.

it was said that it could be just physiological but that we couldn't exclude polycythemia vera. My red blood cells are not much above average (5.8 for a norm of 5.7) and white blood cells and platelets are normal.

however I left for 23 days at altitude but not too high either (500-600m) and I wondered if it could increase my hemoglobin to such a level knowing that I have a high level for years?

Thanks for reading me

john

[charl17]

I wouldn't worry about 500 meters. Are you male or female? This matters because women have fewer red blood cells and less hemoglobin and the normal ranges are sex-specific. For PV the most important number in a blood count is hematocrit which is a measure of the percentage by volume of red blood cells in total blood volume. IF you have polycythemia vera, THEN they will want to control hematocrit below 45%. Proper diagnosis would include checking for one of the JAk2 mutations and if this is positive a bone marrow biopsy.

[nobodth in reply to charl17]

First of all thank you for your reply.

I am a man and regarding my hematocrit it was 49 in 2015 then 51 in 2018 and now 53.

My doctor had told me about a bone marrow puncture...

If I do this test, will I have a definite diagnosis or there are some cases where the test is normal despite polycythemia vera?

thank you

[charl17 in reply to nobodth]

I assume that you are positive for a JAK2 mutation before having the biopsy. If the bone marrow is characteristic of PV then you should consider the diagnosis a practical certainty. Myelofibrosis can also manifest with a high hematocrit. If the bone marrow is normal, I suppose it could still be PV but I think the doctor would be looking for some kind of secondary polycythemia. Unmanaged PV is a risky proposition. I would get it checked out and if your doctor recommends a biopsy I would have it done.

[nobodth in reply to charl17]

no I didn't do any test to check mutations for JAK2. I will call my doctor tonight to see what he wants to do after the blood test we have done today. Thanks for your help!

[Lifam in reply to nobodth]

I really think bone marrow biopsy is important

[nobodth in reply to Lifam]

fortunately my hemoglobin went down to 18 and my red blood cells also came back down the norms. there is just the hematocrit that remains at 52 but the doctor said that it wasn't pathological and that we could stop because for him I'm just on the extreme right of the curve of gauss.

[Wyebird]

Your English is very very good. Regarding being at high altitude I’m sur the doctor will take that into consideration. I have ET so no doubt others will be able to advise you better than I. Good luck.