Patient with elevated haemoglobin

Finding a raised Hb concentration requires a systematic clinical approach for differential diagnosis and further investigation. Initially it is essential to 12 check whether the result ties in with the known clinical findings —if unexpected the FBC should be re-checked to exclude a mix-up over samples or a sampling artefact. Dehydration and diuretic therapy may 4 the Hct and these should be excluded in the initial phase of assessment.

Having determined that the 4 Hb concentration is genuine the issue is whether there is a genuine increase in red cell mass or not, and the explanation for the elevated Hb.

Anoxia is a major stimulus to RBC production and will result in an increase in erythropoietin with consequent erythrocytosis.

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