Dr. Goswami Parth Rajendragiri
Pathology
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Patient's Query
Hello doctor,
I have had ongoing anemia for the past 30 years, my blood slowly disappeared until the last six months requiring transfusions and now on Eprex to help with that. My three bone marrows just show large red blood cells, irregularly shaped, and blasts. Even sent the last marrow and bone biopsy, nothing stood out. I want to trial B12 sublingual despite normal levels as I have digestion issues and I feel it is more of a malabsorption issue. Kindly guide me.
Hello,
Welcome to icliniq.com.
I read your query and understand your concern. For low hemoglobin, you are given a blood transfusion. So the severity of anemia might get more severe as receiving a blood transfusion. Hemoglobin levels should be kept within the limit to get relief from symptoms of anemia. You have not mentioned the peripheral smear report and percentage of blasts in the bone marrow. As blast and abnormal forms are seen in bone marrow, a percentage of it should be known to rule out leukemia or myelodysplasia-like presentation. Your liver, and spleen should also palpate and serum LDH (lactate dehydrogenase), bilirubin, is done to rule out hemolytic anemia. In your case apart from hemoglobin correction, clinical correlation is necessary to do specific treatment if the cause is identified as a rapid decrease in hemoglobin. Acknowledge with bone marrow biopsy report to comment further. Consult a physician or hematologist for an examination. I hope I have cleared all your doubts.
Thank you.
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Pathology
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