Is a blood transfusion needed for Hb 4 and Fe 7 with 1% saturation?

Question

Hello doctor,

My platelet count was 974 microliter, hemoglobin was 4 g/dL, sedimentation rate was more than 140 mm/hr, and iron was 7 micrograms per deciliter with a saturation of one percent.

I went to the doctor because I lost vision in one eye for about an hour. They have done an MRI and an EKG, both of which are normal. Two units of blood and iron transfusions were started in the morning once a week for three weeks. No idea about what is going on.

Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

Your transferrin saturation and Hb seem very low. If you provide a full CBC (complete blood count) report, then it will be clear whether it is iron deficiency anemia or hemolytic anemia. A platelet count here can be as high as a result of reactive thrombocytosis. It is because of IL-6 release and activation of thrombopoietin in certain conditions like post-hemorrhage, inflammatory disorder, infections, iron deficiency anemia, etc.

Your anemia should be treated with a blood transfusion, as this hemoglobin level is very low. After anemia correction, the ESR (erythrocyte sedimentation rate) and CBC reports need to be repeated. ESR is very high in your condition. It suggests some form of infection or inflammation-like condition.

Here, a temporal arteritis-like condition, if needed, can be ruled out by biopsy (if clinical examination favors it). For visual loss problems after anemia correction, an ophthalmologist reference can be done here to do a direct ophthalmoscopy examination and neurological examination if optic nerve affection is present.

I hope this helps.

Thank you.