Hello doctor, I am writing this for my brother. He is a diabetic and taking medicine from the last three years. He recently came to home for a short vacation and undergone health check-ups. After studying the reports, our family doctor pointed out certain elevated values like Hb, etc., and suggested him to consult a Hematologist. Soon, we consulted a Hematologist and he advised him to do certain lab tests. The reports are ready except one that is JAK 2 ARMS PCR. We are little bit worried over him. Kindly go through the attachment and advise us with your valuable opinion. Does he have any serious health related issues? Your prompt reply will be much appreciated.
Hello. I have read the attached report of your brother (attachment removed to protect patient identity). The main abnormal finding in CBC report is elevated red blood cells count and PCV. The hemoglobin level is also raised slightly. So, it is suggestive of polycythemia. It can be secondary which is more common or primary. The primary type include problem in bone marrow for which your brother have been instructed to investigate with JAK2 study. It will help in ruling out primary polycythemia. The secondary cause includes respiratory disease, cardiac disease, chronic smoking, dehydration, etc. So, if any of such history is present or if smoking history is present, then kindly mention it to guide you further. I suggest you drink lots of water at least 2 to 3 liters per day. He needs to stop smoking if he is having habit of it. Additionally I suggest you investigate with chest X-ray, EKG, serum EPO estimation for further work up. Kindly revet back with reports once done including JAK2. He has to repeat CBC after 15 days to check red blood cells and PCV value again. Do not worry. Most of such cases are secondary polycythemia. You can discuss all these with your treating hematologist. Additionally, I want to point you that your brother 's diabetes is not controlled. He need to be given combination of two drugs and life style need to be changed to control sugar.