Unexplained Hematocrit Increase after Therapeutic Phlebotomy in a Patient with Marked Erythrocytosis. (11th August 2022)

• Record Type: Journal Article
• Authors: Machhi, Rushad; Cunningham, Ashley M.; Hennrick, Kenneth; Schaser, Karen A.; Williams, Eliot C.; Rose, William Nicholas
• Other Names: Konstantopoulos Kostas Academic Editor.
• Is Part Of: Case reports in hematology. Volume 2022(2022)
• Publication Date: 2022-08-11
• Subjects: Hematology -- Periodicals; Hematology -- Case studies -- Periodicals; Blood -- Diseases -- Periodicals; Hematology; Hematologic Diseases; Blood -- Diseases; Hematology; Electronic journals; Periodicals; Case studies; Periodicals; Case Reports; Fulltext; Internet Resources; Periodicals; 616.15
• DOI: 10.1155/2022/5018388
• Languages: English
• ISSNs: 2090-6560

Abstract

Abstract : We report a patient with hereditary erythrocytosis who underwent a therapeutic phlebotomy and had a post-phlebotomy hematocrit that was higher than the pre-phlebotomy hematocrit. We could not discern a reason for this hematocrit increase after phlebotomy. Instead of performing another phlebotomy, we performed an automated red cell depletion via an apheresis instrument. This procedure is essentially a red cell exchange, but 5% albumin is used as the replacement fluid instead of red blood cells. The patient's hematocrit decreased from 80% to 39% after three consecutive daily red cell depletion procedures. We share our experience to report the unusual finding of a patient's hematocrit that increased with phlebotomy and to raise awareness of the red cell depletion procedure.