This morning a midwife phoned for the result of a blood count. “Just the Hb” she chirpily announced.
GREEN, TERESA AB+ Queue DOB 25/09/1987 Sex F Pat No 123456 Received 09:40 Address IN A TENT 29/06/2011 Specimen No : AW268935F (Haematology) 24/06/2011 00:00 EDTA Haemoglobin 10.9 g/dl ( 11 to 15 ) White Blood Cells 8.7 10^9/l ( 4 to 11 ) Platelets 412 10^9/l ( 150 to 400 ) Red Blood Cells 4.97 10^12/l ( 3.8 to 4.8 ) Haematocrit 0.370 ratio ( 0.36 to 0.46 ) Mean Cell Volume 73.4 fl ( 80 to 100 ) Mean Cell Haemoglobin 21.9 pg ( 27 to 32 ) Mean Cell Haemoglobin Con 29.9 g/dl ( 32 to 36 ) Neutrophils 6.3 10^9/l ( 2 to 7.5 ) Lymphocytes 1.9 10^9/l ( 1.5 to 4 ) Monocytes 0.4 10^9/l ( 0.2 to 1 ) Eosinophils 0.1 10^9/l ( 0.02 to 0.5 ) Basophils 0.0 10^9/l ( 0 to 0.1 ) XE FLAG1 Iron deficiency ? XE FLAG2 ^A blood film has been reviewed |
A haemoglobin of 10.9 isn’t entirely unexpected in an ante-natal case. But an MCV of 73.4 is indicative of incipient iron deficiency. So I gave her the Hb and the MCV. I could tell from the tone of voice that she had no idea why I’d read out the MCV. So I explained. “But the Hb’s normal” she said. So I explained (briefly) about iron metabolism.
So many people still feel that haemoglobin level and iron status are synonymous. They are not. I can remember having a similar conversation with a midwife when my son (now aged twenty three) was at the ante-natal stage. It would seem that some things never change.
It’s just as well that there’s the likes of me available to advise…..
No comments:
Post a Comment