Mayo Clinic Talks Lab Medicine Edition | CBC: Hemoglobin/Anemia (Micro, Macro, Hemolytic)
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Apr 25, 2024 Renowned Mayo Clinic Hematologist, Dr. Ronald S. Go, discusses evaluating abnormalities in hemoglobin levels, different types of anemia, and the importance of clinical context and confirmatory testing. Topics include non-heme causes of polycythemia, diagnostic approach for polycythemia vera, differential diagnosis and workup for anemia, diagnostic value of Mean Corpuscular Volume in anemias, and guidance on anemia testing and hemoglobin interpretation.
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Evaluating Elevated Hemoglobin
- When evaluating an elevated hemoglobin, consider if it's a blood disorder or a secondary cause.
- Repeat the CBC to confirm true elevation and then investigate further.
Common Causes of Elevated Hemoglobin
- The most common causes of elevated hemoglobin are hemoconcentration, hypoxia (COPD, cardiac issues), and medications.
- Less common causes include post-renal transplant, renal cancer, and rare hereditary conditions.
Testing for Polycythemia Vera
- If secondary causes are ruled out and polycythemia vera (PV) is suspected, order a JAK2 mutation panel.
- A positive result indicates PV, while a negative result suggests revisiting secondary causes or an e-consult.