causes of anemia with leukopenia

[kcbrouwer]

Hi there,

My dad has anemia and leukopenia (Low: WBC, RBC, HgB, Hct, ferritin; very low total (retics) and ret %

However, he has normal levels of MCV, MCH, MCHC, RDW, PLT,  Levels and % of NE, LY, MO, EO and BA are in the  normal range

In an iron panel, iron was fine as was UIBC, TIBC and Iron % Sat

He has diabetes but keeps it under control primarily with a very strict diet (weighs about 150lbs and is 6ft)  and oral medication.  He had rheumatoid arthritis when he was young and occasionally has arthritic episodes, but he is not on any medications for this.

He's had anemia and low WBC for many months now, but otherwise appears healthy.  Are there things we should suggest his doctor explore?  Thank you

[Londres70]

Well, he needs RF, CRP and ESR done for starts.  

How long ago were the above labs done?  If not recent, they should be repeated asap.  

Then go from there.  The lab results will determine if he needs to see a Rheumatologist or a Hematologist.  

[kcbrouwer]

Thanks for asking.  The abnormal lab values with the lab reference ranges are:

WBC 4.4 (4.5-11)
RBC 4.1 (4.4-5.9)
Hgb 12.1 (13.5-17.5)
Hct 35.8 (39.8-52.2)

Reticulocyte panel
RBC 4.1 (4.4-5.9)
Total retic  8.1 (25 - 75)
Ret % 0.2 (0.5-1.5)
Index  0.2 (0.5-1.5)
Ferritin 26 (30-400)

For diabetes, he takes
Metformin  1000 mg twice a day

He also takes Simvastatin 20 mg

He hasn't had a RF lab in many years

Any insights would be greatly appreciated.

[Londres70]

Has he had a RF (Rheumatoid Factor) lab along with inflammatory markers (CRP and ESR) done?

What meds is he taking for the Diabetes?

BTW:  It would be helpful to have the abnormal labs posted with the exact number and the lab reference ranges.