Most Recent Expert Reports

Expert Report of Dr. Douwe de Boer reads, in part:

17 April 2024

Conclusions and remarks:

1. In my expert opinion 11cSAVI22.u I wrote that the fluctuations in the overall athlete’s ABP could be attributed primarily to his alcohol abuse problem;

2. In my expert opinion 24hSAVI 22.u I also wrote that the concentration of ethyl glucuronide in the athlete’s urine samples presented and made available by the anti-doping authorities were significantly elevated and prove the intake of alcohol over a long period; the absence of elevated concentrations of ethyl glucuronide also proves periods of abstinence of alcohol;

3. Overall, I concluded previously while specific changes in the ABP cannot be interpreted specifically without knowing the status of iron, folate, vitamin B12, it is obvious that the intake of ethanol must have caused the overall changes in the ABP; the diversity of intake of ethanol alternated with abstinence of alcohol combined with altitude training and inconsistent intake of iron, folate and vitamin B12 obviously must have enforced the significant fluctuations in his ABP;

4. The simulation experiment of ethanol intake as described in this specific expert opinion supports the above indicated conclusions; moreover, it can not be excluded that the inhibitory effect of ethanol on G6PD enzyme activity at least may resulted in an occasional ethanol-induced hemolysis;

5. Therefore and once more, all available evidence clarifies that the fluctuations as well as the overall changes in the athlete’s ABP indeed must be attributed mainly to his alcohol abuse problem combined with secondary factors.

Assessing the impact of alcohol consumption on the genetic contribution to mean corpuscular volume

The Effects of Ethanol on Glucose 6-Phosphate Dehydrogenase Enzyme Activity From Human Erythrocytes In Vitro And Rat Erythrocytes In Vivo

Expert Report of COL (GS) Miloš Bohoněk, M.D., Ph.D. and Prof. Jaroslav Čermák, M.D., Ph.D. reads, in part:

16 April 2024

Family history: father and 2 uncles polyglobulin/polycythaemia**, mother healthy, 1 brother and 3 sisters allegedly health.

Molecular biology:

JAK-2 V617F mutation, mutation in codon W151 of MPL gene, mutation in exon 9 region of CALR gene - all negative

bcr/abl (major, minor, micro) – negative

mutation in the gene for G-6-PD (Xq28) - positive

EpoR (Erythropoietin receptor) – negative – we recommend performing examination of the athlete by NGS (next-generation sequencing) panel for congenital erythrocytosis which also covers other genes associated with this disease

Bone marrow trepanobiopsy from the hip bone flap 15.2.2024:

Morphological examination of marrow smear from aspirate: hypocellular smear, multiplied lymphoid population (39,5%)

Histological examination: hypocellular trilinear haematopoiesis with reactive changes Immunophenotyping (flow cytometry): no evidence of haematological malignancy

Cytogenetic examination: normal karyotype (46 XY)


Hypocellular hematopoiesis with a multiplied lymphoid population indicates an incipient hematopoietic disorder with a number of possible etiologies in terms of NHL (Non-Hodgkin lymphoma) or hypocellular MDS (Myelodysplastic syndrome). On the other hand, low serum erythropoietin levels* are indicative of increased endogenous erythropoiesis activity and preclude external administration of growth factors such as erythropoietin.

The results of the examination show, among other things, that the observed non-standard fluctuations in hemoglobin values in the so-called biological passport of the patient in the years 2020 - 2022 are likely caused by a primary disorder of hematopoiesis, i.e. a primary haematological disease and not by external interventions. Influence of secondary factors such as alcohol abuse of the patient to the fluctuations of the haematological values of the patient cannot be ruled out.

*3.2 UI/l (normal 9.5-25.0) – 14.02.2024

**father and 2 uncles polyglobulin/polycythaemia

02 June 2023

Boniface Tanui (uncle) - HGB: 20.0 g/dL — RBC: 6.95 10^6/uL

28 July 2023

Gilbert Kiptoo (father) - HGB: 18.0 g/dL — RBC: 6.09 10^6/uL

Silas Komen (uncle) - HGB: 17.8 g/dL — RBC: 5.97 10^6/uL

30 September 2023

Gilbert Kiptoo (father) - HGB: 18.1 g/dL — RBC: 6.23 10x12/L

Boniface Tanui (uncle) - HGB: 19.3 g/dL — RBC: 6.72 10x12/L

Silas Komen (uncle) - HGB: 17.3 g/dL — RBC: 5.81 10x12/L

27 January 2024

Gilbert Kiptoo (father) - HGB: 19.1 g/dL — RBC: 6.58 10x12/L

Boniface Tanui (uncle) - HGB: 18.3 g/dL — RBC: 6.38 10x12/L

Silas Komen (uncle) - HGB: 15.9 g/dL — RBC: 5.46 10x12/L


Hematologically, currently no curative measures, but dispensation and regular haematological follow-ups are advisable, at least after 6 months ("Watch and Wait"). Furthermore, any major secondary factors (such as the excessive alcohol consumption of the patient, and/or significant fluctuation of the patient’s athletic training loads) shall continue to be monitored. The examinations recommended above (such as NGS panel for congenital erythrocytosis) shall be performed.

At the next follow-up, in addition to checking the blood count, erythropoietin values and biochemical examination, beta-2 microglobulin and ELFO proteins with immunofixation.


8 May 2024 - Report delivered  to Rhonex and his team after the matter was heard on 22 April 2024

I hope that in time my medical diagnosis will be clear both for myself and for this case. I don't cheat or dope! The truth is on my side. This is all I can say.

Rhonex Kipruto

22 April 2024


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