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Hematology/probing bone marrow after using anticlotting agents

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Question
Hello,
I have a 95 year old mother who has been taking anti-clotting medicine for leg clots. she has low red-blood count and high white-blood count. The cause has not been found. other complication has been renal inflammation. Leukemia is a possibility but the doctors cannot find out while she is taking the anti-coagulants. Is there another way of discovering leukemia?
oN THE OTHER HAND, is it possible to stop with the anti-clotters long enough not to be dangerous and yet allow the bone marrow probe to be done? hOW LONG WOULLD it have to be stopped, while being safe?
Any other suggestions?

Answer
Hey Greg!
Warm welcome to you!
There are different ways to diagnose leukemia, but they are suitable in only certain types of leukemia. Like you can get the lymph node biopsy done. Routine tests would be complete blood count, Peripheral Blood Smear and bone marrow examination. Do you have the reports of complete blood count? If yes please send. So what anti-coagulant medication is she taking. Normally aged patient like her can skip the anti-coagulant medications for 2-3 days but not more than that. But after stopping the medicines the bone marrow takes lot of to time (15-30 days) to come back to normal state. It all depends whether we are suspecting acute/chronic leukemia. In acute form you can see quick changes in bone marrow.

Its not recommended for aged person like her to stop the medications long enough for the tests. Because the clots formed can lodge in lungs, heart or even brain and cause sudden death. So need to be very careful.

Anyway her peripheral blood smear should give fair amount of diagnosis. Have they tested PBS? To investigate any visible damage to bones, they can even get the x ray done.

I have another suspecion about her condition. For how long she has been on anti-coagulants now?

Anyway keep me posted. take care. Bye.

Hematology

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Dr.Shrinidhi Kulkarni

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I can answer all questions related to hematology. RBC, WBC, Platelet and blood forming organs etc and related questions. hematology also includes blood proteins, hemoglobin and disorders related to clotting abnormalities. So questions about all aspects of hematology are welcome!

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Working as a Doctor in Primary Health care Centre.

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KIMS Banglore

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MBBS, Internship in Internal Medicine

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