Hematology deals with diseases of the hematopoietic and lymphatic organs, and one branch of it deals with disorders of blood clotting.

Fortunately, severe hematopoietic diseases are rare, but abnormalities in blood counts are very common during routine blood sampling. Complicating matters is the fact that in Hungary, blood tests mean one thing in an everyday sense and something different in a medical sense. According to the vernacular, ‘complete blood count’ is the collective term for all tests performed on blood samples. However, doctors only mean a certain test: an examination of the blood's components, such as white blood cells, red blood cells, a platelet (thrombocyte) count and a few other parameters that are mainly indicative of the condition of the blood (for example hemoglobin, the hematocrit level, or the distribution of white blood cells). Quantitative changes in any of these can disturb the functioning of the body, whether the amount is higher or lower than necessary. It is also possible for several different cellular elements to increase or decrease simultaneously.

With what kind of irregular blood counts should you consult a hematologist?

  • If you have anemia. The most common cause of this is iron deficiency anemia. The symptoms of anemia are very common: weakness, dizziness, pallor. The hemoglobin value is usually 110g/L or less.
  • If you have a prolonged white blood cell count that is too low for months (<4.0g/L), or permanently too high (>12-14g/L), or if there is an abnormal proportion of white blood cell subtypes in the blood count.
  • With a platelet (thrombocyte) count <100g/L, or rather it is between 150-100g/L but has a decreasing tendency.

Often, abnormal blood counts do not indicate inherent damage to the lymphatic organs and bone marrow but are symptoms of another disease. This is the case with most anemia, but there can be an underlying infection, a so-called autoimmune disease, chronic liver disease, etc., or even an innocent phenomenon that does not require treatment.

Regarding the most common blood abnormality, it cannot be stressed enough that the actual iron deficiency anemia’s cause must always be sought, and most cases do not involve an underlying hematological disease. Finding out the cause of iron deficiency can be undertaken by any doctor who notices abnormalities in the blood count.

In addition to abnormal blood counts, enlargement of the lymph nodes and spleen may also indicate hematological disease.

Some of the well-known diseases in the field of hematology (in addition to anemia) are: Leukemias (abnormal white blood cells), lymphomas (malignant lymphoid tumors), blood clotting disorders (inherited or acquired forms of increased clotting, tendency to thrombosis, or even hemophilia).

You may suspect lymphoma if you have 1-3 of the following general symptoms:

  • recurrent fever or a temperature above 38.1C for at least 3 weeks - if an infectious origin can be ruled out.
  • very heavy night sweats (requires a change of pajamas and bed linen and occurs every night)
  • if you lose at least 10% of your body weight in six months and other causes, much more common than lymphoma, have been ruled out.
  • palpation of a lump on the neck, shoulder cavity, armpits, or other parts of the body.

If someone develops symptoms of aterial or deep vein thrombosis, emergency medical care is paramount. Starting treatment for deep vein thrombosis in Hungary usually requires hospitalization, exceptionally treatment can be arranged at home, but this is really very rare.

A hematologist can assist in interpreting a genetic test for inherited or acquired thrombotic predisposition or in deciding what to do in the case of an acquired or inherited thrombotic predisposition in situations where the risk of developing thrombosis is increased (e.g., surgeries, pregnancy, hormone replacement, etc.).

What happens during a hematological examination?

  • In addition to medical records and a physical examination, lab tests are usually required, which, in addition to a general blood test may also involve state-of-the-art and highly specialized (molecular, genetic) laboratory procedures.
  • In some cases, cytological or histological analysis of bone marrow or lymph nodes is also required. Sampling for this purpose can be routinely performed as an outpatient for the most part.

- Of course, other tests may be needed for an accurate diagnosis, such as endoscopic examinations, ultrasound, CT, PET-CT, or MRI scans.