Unexplained Hematocrit Increase after Therapeutic Phlebotomy in a Patient with Marked Erythrocytosis

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...

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Main Authors: Rushad Machhi, Ashley M. Cunningham, Kenneth Hennrick, Karen A. Schaser, Eliot C. Williams, William Nicholas Rose
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:Case Reports in Hematology
Online Access:http://dx.doi.org/10.1155/2022/5018388
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author Rushad Machhi
Ashley M. Cunningham
Kenneth Hennrick
Karen A. Schaser
Eliot C. Williams
William Nicholas Rose
author_facet Rushad Machhi
Ashley M. Cunningham
Kenneth Hennrick
Karen A. Schaser
Eliot C. Williams
William Nicholas Rose
author_sort Rushad Machhi
collection DOAJ
description 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.
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institution Kabale University
issn 2090-6579
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publishDate 2022-01-01
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series Case Reports in Hematology
spelling doaj-art-e76e0bad7f2e4e8bb3cbd8d9c15d885a2025-08-20T03:26:10ZengWileyCase Reports in Hematology2090-65792022-01-01202210.1155/2022/5018388Unexplained Hematocrit Increase after Therapeutic Phlebotomy in a Patient with Marked ErythrocytosisRushad Machhi0Ashley M. Cunningham1Kenneth Hennrick2Karen A. Schaser3Eliot C. Williams4William Nicholas Rose5Department of Pathology and Laboratory MedicineDepartment of Pathology and Laboratory MedicineDepartment of Pathology and Laboratory MedicineDepartment of Pathology and Laboratory MedicineDepartment of Pathology and Laboratory MedicineDepartment of Pathology and Laboratory MedicineWe 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.http://dx.doi.org/10.1155/2022/5018388
spellingShingle Rushad Machhi
Ashley M. Cunningham
Kenneth Hennrick
Karen A. Schaser
Eliot C. Williams
William Nicholas Rose
Unexplained Hematocrit Increase after Therapeutic Phlebotomy in a Patient with Marked Erythrocytosis
Case Reports in Hematology
title Unexplained Hematocrit Increase after Therapeutic Phlebotomy in a Patient with Marked Erythrocytosis
title_full Unexplained Hematocrit Increase after Therapeutic Phlebotomy in a Patient with Marked Erythrocytosis
title_fullStr Unexplained Hematocrit Increase after Therapeutic Phlebotomy in a Patient with Marked Erythrocytosis
title_full_unstemmed Unexplained Hematocrit Increase after Therapeutic Phlebotomy in a Patient with Marked Erythrocytosis
title_short Unexplained Hematocrit Increase after Therapeutic Phlebotomy in a Patient with Marked Erythrocytosis
title_sort unexplained hematocrit increase after therapeutic phlebotomy in a patient with marked erythrocytosis
url http://dx.doi.org/10.1155/2022/5018388
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AT kennethhennrick unexplainedhematocritincreaseaftertherapeuticphlebotomyinapatientwithmarkederythrocytosis
AT karenaschaser unexplainedhematocritincreaseaftertherapeuticphlebotomyinapatientwithmarkederythrocytosis
AT eliotcwilliams unexplainedhematocritincreaseaftertherapeuticphlebotomyinapatientwithmarkederythrocytosis
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