Q: My 74 years old mother is very thin weighing only 35 kg and her height is 150 cm. She is quite prone to colds and coughs. Her recent blood examination shows - haemoglobin count: 7.2 g/dl, red blood cells: 2.02 million/ml, white blood cells: 5150/ ml -, neutrophils: 36%, lymphocytes: 59%, eosinophils: 03%, monocytes: 02%. Smear: mild lymphocytosis. ESR: 40 mm atend of 1 hr, haematocrit (PCV) 26%. Her haemoglobin count has been low for the last 2-3 years. She always complains of gastritis and had an ulcer operation done when young. Please suggest.

A:From the details given, your mother is definitely underweight for her height (She should have been somewhere around 50 kg). I presume that this is probably on account of inadequate intake of a proper diet, which in itself could be related to the acid-peptic disease that she complains of. As far as her counts are concerned, she is definitely anaemic at a haemoglobin of 7.2 g/dl with a low RBC count as well. We now need to find out whether this is on account of some kind of blood loss or is it due to inadequate synthesis from the bone marrow. To start with, one can get a reticulocyte count done and, if need be, a bone marrow examination would also be required. Also, the lymphocyte percentage is on the higher side, which would need further investigation. I, therefore, suggest a consultation with a clinical hematologist for all this.