CBC reading

Q: 47 years old African-American male is admitted to ICU with acute bleeding due to esophageal varices. Serial CBC shows, a parallel decrease in Hemoglobin (Hb) and Hematocrit (HCT) but an inverse increase in RBC count. What could be the underlying disease?

Answer: Thalassemia

In patients with anemia, Hb, HCT, and RBC count usually decrease in parallel except in patients with thalassemia. This is due to severe microcytosis.

The incidence of thalassemia is relatively high in the African-American population and suggests the underlying pathology of thalassemia.

#hematology

Reference:

Munkongdee T, Chen P, Winichagoon P, Fucharoen S, Paiboonsukwong K. Update in Laboratory Diagnosis of Thalassemia. Front Mol Biosci. 2020 May 27;7:74. doi: 10.3389/fmolb.2020.00074. PMID: 32671092; PMCID: PMC7326097.