Blood hemoglobin level

Anemias, reductions in the number of red blood cells or of hemoglobin in the blood, can reflect impaired synthesis of hemoglobin (eg, in iron deficiency Chapter 51) or impaired production of erythrocytes (eg, in folic acid or vitamin Bjj deficiency Chapter 45). Diagnosis of anemias begins with spectroscopic measurement of blood hemoglobin levels. 

Mallard ducks fed up to 10,000 ppm diisopropyl methylphosphonate in feed for up to 24 weeks showed no significant effects on blood hemoglobin levels, leukocyte count, and hematocrit (Aulerich et al. 1979). Doses could not be calculated in mg/kg/day because food intake and body weights were not measured in this study. 

Dose-Response Data Related to Dietary Iron. At the outset it seemed important to determine the nature of the dose-response curve relating dietary iron to blood hemoglobin levels. 

From these observations it is evident that the dose-response relationship between dietary iron and blood hemoglobin level is highly dependent upon the amount of protein in the diet. And indeed the different conclusions that have been expressed in relation to the iron requirement are only interpretable if one specifies the nature and amount of protein in the diet. One could extend this further and say that conclusions based on animal work, using high protein diets, may be of questionable value when one is interested in human experience with malnourished populations consuming diets with small amounts of low quality protein. 

A case-control study of Guiguet et al. observed an increased risk for aplastic anaemia after exposure to paints (effective compounds in the paints are unknown), but no increased risk after exposure to solvents alone. Reduction of blood hemoglobin levels was shown after exposure to gasoline, car spray paint (xylene) and various solvents (house painters).An increased Hb level was noted, however, in a study of car and industrial spray painters. 

Monitor blood glucose several times daily in patients with CFRD or those taking systemic corticosteroids. Follow glycosylated hemoglobin levels on an outpatient basis to assess long-term glucose control. Levels may be falsely low in CF due to a shorter red blood cell half-life. 

Measure blood glucose levels at baseline and every 3 months to assess for glucose intolerance and insulin resistance. Periodic measurement of glycosylated hemoglobin (HbAlc) also may be useful.34... 

Closely monitor patients for efficacy and toxicity while they are receiving hydroxyurea. Monitor mean corpuscular volume (MCV) because it increases as the level of HbF increases. If the MCV does not increase with hydroxyurea use, the marrow may be unable to respond, the dose may not be adequate, or the patient may be noncompliant.27 HbF levels also can be monitored to assess response. Assess blood counts every 2 weeks during dose titration and then every 4 to 6 weeks once the dose is stabilized. Temporary discontinuation of therapy is warranted if the hemoglobin level is less than 5 g/dL (50 g/L or 3.1 mmol/L), the absolute neutrophil count is less than 2000/mm3 (2 x 109/L), platelets are less than 80,000/mm3 (80 x 109/L), or reticulocytes are less than 80,000/mm3 (80 x 109/L) if the hemoglobin is less than 9 g/dL (90 g/L or 5.6 mmol/L). Monitor for increases in serum creatinine and transaminases. Once the patient has recovered, hydroxyurea may be restarted with a dose that is 2.5 to 5 mg/kg less than the dose associated with the patient s toxicity. Doses then may be increased by 2.5 to 5 mg/kg daily after 12 weeks with no toxicity. 

Patients may have a low hemoglobin level from blood loss. 

Two intermediate-duration studies examined hematological parameters (e.g., red blood cell levels, hemoglobin levels) following dermal exposure to organophosphate ester hydraulic fluid. No hematological... 

Fed diets containing 25 mg Pb/kg, as lead nitrate, for 12 weeks No deaths no pathology no significant accumulations of lead in liver, kidney, or bone no changes in hemoglobin or hematocrit decrease in blood ALAD activity, and increase in blood lead levels — both returned to normal diet within 3 weeks on lead-free diet 8... 

After an erythropoietic agent is initiated, hemoglobin response is typically delayed. Steady-state hemoglobin levels do not occur until after the life span of a red blood cell (mean 2 months range 1 to 4 months). To avoid... 

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