Hematology is a medical specialty focused on the diagnosis and treatment of diseases affecting blood, blood-forming tissues, and the hemostatic (blood clotting) system.
Patients visit a hematologist not only for serious conditions such as leukemia or lymphoma but also when abnormalities are detected in routine blood tests. Namely, in cases of bleeding disorders, susceptibility to thrombosis, unexplained enlargement of lymph nodes, or persistent symptoms lacking clear explanation, such as fever or weight loss.
Common problems that lead patients to consult a hematologist:
- Anemia
- Blood clotting disorders (e.g., hemophilia, thrombocytopenia)
- Leukemia
- Lymphomas and other diseases of the lymphatic system
- Polycythemia (increased red blood cell count)
- Immune disorders related to blood conditions
Anemia is the most common reason for consulting a hematologist.
Anemia is a condition characterized by a reduced level of hemoglobin and/or decreased number of red blood cells in the blood, leading to insufficient oxygen delivery (hypoxia) to the body's tissues.
Symptoms of anemia:
- Increased fatigue and weakness
- Pale skin and mucous membranes
- Shortness of breath and rapid heartbeat during physical exertion
- Dizziness, tinnitus, headache
- Cold hands and feet
- Reduced concentration and diminished work performance
Main causes of anemia:
- Iron deficiency – the most common type of anemia
- Deficiency of vitamin B12 or folic acid
- Chronic blood loss (e.g., peptic ulcer disease, hemorrhoids, heavy menstruation)
- Chronic diseases (e.g., kidney disease, rheumatoid arthritis)
- Bone marrow disorders (leukemia, aplastic anemia)
When should you see a hematologist?
A hematologist is a specialist whom patients are often referred to by general practitioners, gynecologists, or other specialists. However, it’s important to see a hematologist proactively if you notice persistent or recurrent symptoms or abnormal blood test results.
When to consult a hematologist:
1. You have a diagnosed blood disorder requiring ongoing monitoring or treatment follow-up.
2. You experience symptoms such as:
- Increased bleeding (nosebleeds, bleeding gums, heavy menstruation)
- Unexplained bruising, prolonged wound healing
- Night sweats, fever, weight loss
- Enlargement of lymph nodes or spleen
3. You have abnormal blood test results:
- Anemia (low hemoglobin)
- High hemoglobin or hematocrit (erythrocytosis)
- Low/high platelet counts
- Leukopenia, leukocytosis
- Elevated ferritin (above 200 µg/L in women, 300 µg/L in men)
- Increased clotting times (APTT, INR/PT)
4. You have experienced thrombosis or are at risk:
- History of deep vein thrombosis or pulmonary embolism without a clear cause
- Family history of thrombosis, pulmonary embolism, or stroke at young age
- Diagnosed genetic predisposition to thrombosis (e.g., Factor V Leiden, prothrombin mutation) or family history of thrombophilia
- Planning pregnancy with known thrombophilia
- IVF planning with known thrombophilia or recurrent pregnancy loss
- History of recurrent miscarriages without clear cause
- Suspicion of antiphospholipid syndrome
5. You are pregnant and have:
- Abnormalities in routine blood tests
- Diagnosed thrombophilia
- Anemia unresponsive to iron supplementation
6. In complex situations during treatment of other conditions:
- Ineffective iron supplementation for anemia
- Neutropenia during antidepressant therapy
- Changes in blood tests associated with liver diseases
- Changes in blood tests associated with lung diseases
- Changes in blood tests associated with cardiovascular diseases
What does a hematologist do?
A hematologist specializes in:
- Interpretation of blood test abnormalities: anemia, thrombocytopenia, leukopenia, leukocytosis, thrombocytosis, changes in blood smears.
- Diagnosis and treatment of hereditary and acquired thrombophilias.
- Management of patients with increased risk of thrombosis.
- Consultations regarding pregnancy complications, including suspected antiphospholipid syndrome (APS).
- Consultations for abnormalities in blood tests during pregnancy and postpartum.
- Diagnosis and treatment of bleeding disorders — from frequent nosebleeds to severe coagulation disorders.
- Diagnosis and treatment of conditions such as anemia, thrombocytopenia, myeloproliferative diseases (polycythemia vera, essential thrombocytosis, myelofibrosis), as well as hematological manifestations of systemic diseases (liver disorders, autoimmune and rheumatologic conditions, etc.).
- Selection, monitoring, and adjustment of anticoagulant therapy (warfarin, DOACs, LMWH) when requested by or consulting other specialists.
- Collaboration with other specialists — gynecologists, rheumatologists, internists, and hepatologists — in complex clinical cases.
What examinations might be needed?
During your visit, the hematologist may prescribe the following tests:
- Extended complete blood count with differential and reticulocyte count
- Coagulation profile (coagulogram)
- Tests for antiphospholipid antibodies and thrombophilia markers
- Biochemical markers (ferritin, vitamin B12, LDH, liver function tests, kidney function tests, etc.)
- If needed – comprehensive hemostasis evaluation, genetic studies, abdominal ultrasound, bone marrow examination, molecular diagnostics, consultations with related specialists.
Tests are selected individually based on your medical history and symptoms.
How does a hematologist consultation proceed?
- Analysis of your symptoms, medical history, and family history
- Review and interpretation of previously completed tests
- Physical examination and prescription of additional tests (if necessary)
- Establishment of a diagnosis or preliminary conclusion
- Development of a management plan: follow-up, therapy, and additional consultations
Consultations are conducted confidentially, with careful attention and sensitivity to every detail.
