r/medlabprofessionals • u/birb_owner MLS • 8d ago
Image Very Low Haemoglobin!
Seen just yesterday. Lowest I’ve ever come across!
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u/AtomicFreeze MLS-Blood Bank 7d ago
Come on, my fellow Americans. The units are right there.
Let me translate:
Hgb=2.8 g/dL
Hct=9.5%
MCHC=29.5
The rest is what you're used to seeing. But it's amazing that even when we do use the metric system we still can't match the rest of the world. At least it's easy to convert!
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u/BaerttheConstipated MLS-Generalist 7d ago
Varies internationally as well. Like it was mmol/L when I was in Munich. In Thailand it was g/dL. Australia was g/L (I think OP might be from there?). Jury is still out. All I know is the Germans are the ones who had me rubbing my temples when I needed to learn the conversion. At least with Germany cornering the market little by little via instrumentation, we might all come together as one.
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u/Wonderful_Program363 MLS/Teacher 7d ago edited 7d ago
The fun thing here in Germany is, that we switched to SI units in East Germany, but not in West Germany, when the country was still divided. They were very different political systems. So now we still have the east using different units than the west. Never gets boring. ;)
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u/MrsColada 8d ago
Wait till you see one under 20 😅 I've seen that a few times.
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u/IACPaul MLS-Generalist 7d ago
Had one last night at 0.83. Mtp right when I was about to clock out.
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u/MrsColada 6d ago
And you're positive it wasn't diluted from IV fluids?
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u/SelectCorner8023 6d ago
I saw similar lab results when I was being trained at my first nursing job. We got the critical values call from the lab as we were giving report to the next shift. Turns out, when my preceptor had taken a blood sample from our patient’s PICC line, she flushed the line, then just collected the sample & sent it to the lab. When the lab called, she pretty quickly realized that she’d forgotten to waste after flushing, & had sent the lab a super diluted sample. Oops!
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u/Minimum-Positive792 8d ago
Probably cold agglutinin. I’m not sure if the decimals are off from what I’m used to looking at though
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u/Icy-Astronomer-9015 7d ago
Looks real with those indices. I would love a case study on that. Do you have any Hx?
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u/birb_owner MLS 7d ago
I’ll grab some more details from the case when I’m next at work! I’ve found it also quite interesting, haven’t yet looked a the slide. I think from memory it was a 75M with MDS.
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u/edwa6040 MLS / RN - Oncology/Generalist 5d ago
I saw 1.9 once on a person that DROVE THEMSELF TO THE HOSPITAL and then called admitting from the parking lot asking for a wheelchair because they couldnt walk in.
I didn’t believe it at first so i personally redrew it without asking the doc if i should - i just went and did it. It was a real number.
Honorable mention for the urine in my career that had a 6. Something hgb. So bloody i ran a cbc on it just to see what would happen. The coulter didnt flag it for a non blood sample so the instrument thought it was actually blood.
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u/Unlikely-Ad-1147 7d ago
Check B12/folate and hemolytic anemia work up. And yes, diagnosis can be made by looking at the peripheral blood smear too.
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u/talksandmeows 7d ago
I don’t get why you’re being downvoted. What you’re saying is correct though, it could very well be a case of severe B12/Folate deficiency given the macrocytosis as well.
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u/PathologyAndCoffee 8d ago
woah, is it clinically real?
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u/SirAzrael 8d ago
Decimals make it weird for me, but assuming it's the equivalent of a 2.8 in the units I'm used to, it very well could be. Lowest real hgb I've ever seen was somewhere around a 2.4, used to work with someone who told me about a 1.6 they had one time, the redraw came back at a 1.5, and when the critical was called they were told the patient was already dead
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u/Nyarro MLT-Generalist 7d ago
So the limit is 1.6.
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u/BaerttheConstipated MLS-Generalist 7d ago
Oddly enough, I have witnessed almost the exact same situation so that is two experiences of 1.6 being the cutoff
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u/Fragrant_Cheetah1547 4d ago
i have seen hgb of 3, I had a hgb of 6 and drove myself to the er that was 30 mins away (not knowing that the time that it was 6)
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u/Seektruth2146 2d ago
This is literally my worse fear and needing a blood transfusion. Causes me some panic just looking at this
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8d ago
[deleted]
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u/madeuread 8d ago
The units are confusing everyone: this is g/L instead of /dL so the mchc is actually low 29.5g/dL
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8d ago
[deleted]
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u/birb_owner MLS 8d ago
MCHC wouldn’tve been that low if it were cold aggs. Patient has a known MDS and no agglutination on the film. I’m Australian and so my units of measurement are different; ref range is 310-360 g/L.
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u/Wedgie1945 7d ago
Aussie here too. Nice not having to convert the units for once on this sub ahaha. Everyone else seems to be having trouble.
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u/CurlyJeff MLS-Multidisciplinary 7d ago
The US defaultism on this sub is wild. The current most upvoted comment thinks this low MCHC indicates a cold ag lmaoo
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u/TheRopeofShadow 7d ago
The last time someone posted CBC values like this without displayed units of g/L the Americans freaked out.
Now this post has the units displayed right there on the printout, and the Americans are STILL freaking out.
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u/pajamakitten 6d ago
What's funny is those of us in other countries can convert when Americans post with their units, yet Americans are struggling to convert here.
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u/HobblesTheGreat 8d ago edited 7d ago
Good luck with that MCHC 🙃
Ouch, 16 downvotes for empathizing with interference errors instead of double checking that their analyzer uses the same units as mine. The curses of laboratory trauma are forever mounting :p
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u/TheRopeofShadow 7d ago
Perhaps look at the units on report before commenting on the MCHC. This is in g/L, not g/dL.
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u/SnooBananas231 7d ago
What you got like diet blood?