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Ask Dr. D. Love Your Own Question

Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 17651
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I went into hospital yesterday for a blood transfusion.I was

Customer Question

I went into hospital yesterday for a blood transfusion.I was give 3units group o neg.I was very anaemic.level66,as i recall a nurse saying.It appears since my last blood test in february which were fine,that i now have an autoimmune problem.I have also got cellulitus on my lower leg and have been taking fluoxacillin and my penicillin which i am taking for life due to my accident.I had this accident in 2005,i cut my right foot and developed a rapid sterps infection in Devon,which was levelled at type G.I was given various anti=biotics,and only responded to linizolide.I had lumber punch and ct scan at the time ,because it looked like it was all symptoms of menengitis.Thankfully the anti-biotic saved my leg and saved my life,but has left me with low immunity.I still have my spleen.I am 61 and female,but i would like to know what the problem might be.I don't have any problems with bowels and i don't feel like it could be an ulcer.I have had a stressful year and i look after my elderly mother.
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. D. Love replied 2 years ago.
Hello from JustAnswer. I will be glad to assist you today.
It will help if you could provide some further information.
Do you have the full report from the blood count prior to transfusion?
Were other tests done, such as iron profile, vitamin B12 level, folic acid level, Coomb's test? If so, do you have these results?
What type of autoimmune problem do you have?
Customer: replied 2 years ago.

Sorry for delay,i have rung my surgery,they are giving me a print out as there are so many.She did give me some over the phone.B12 =296. Serumfolic=8.9 .Haemaglobine =66. RBC=3.51. HCT=0.236. MCV=67.2. MCH18.9. They would not e-mail them.I have also said that i have been on 500mg fluoxacillin since 12th sept and cellulitis is no better,but has not spread.

Expert:  Dr. D. Love replied 2 years ago.
A significant anaemia with a low MCV of 67 and an MCH of 18.9 suggests iron deficiency. Checking an iron profile and ferritin levels would confirm that iron deficiency is the cause.

However, that would still not fully explain the cause, as iron deficiency typically means that there is some source of blood loss, usually in the gut. Yes, chronic blood loss from an ulcer can be a cause, but in someone in their 60s, the first concern would be that there has been chronic blood loss from a problem the colon, such as from a polyp or colon cancer, or certain other problems, such as vascular abnormalities or diverticular bleeding.

In this situation, it is appropriate to first stabilize the blood, as your doctor is doing, but after stabilization, the usual next step would be to perform a colonoscopy.

If I can provide any further information, please let me know.
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 17651
Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.
Dr. D. Love and other Medical Specialists are ready to help you
Customer: replied 2 years ago.

Thank you,they have suggested firstly a camera down throat followed by colonoscopy,I have been slightly gluton and lactose intolerant for some years,but avoid eating such foods.I have just been requested to go back to Aand E re my cellulitis.Many thanks for your help thus far, Jean XXXX,Nairn Scotland.

Expert:  Dr. D. Love replied 2 years ago.
It is fine to do the endoscopy at the same time as the colonoscopy, but the greater concern is that there is a problem in the colon, so that evaluation should not be delayed once the acute problems have been stabilized.
Customer: replied 2 years ago.

Many thanks for your advic.I was admitted into Inverness Raigmore hospital last friday and discharged on Sunday.I have been given a very high dose 2,400 mg of clindamycin, for 10 days,to control the cellulitus and thrombose phlebitus in the smaller veins in my right lower leg.I had a scan and there was no sign of DVT.I am still unwell,and will probably have stool sample tested tomorrow.The high dose is not helping with my gut,but they want this aggresive infection cleared up before they look into the other blood loss problem.Once again,thank you.

Kind regards,

Jean Peck.

Expert:  Dr. D. Love replied 2 years ago.
You're welcome.

I hope that you get well soon.

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