Hi, Welcome to icliniq.com. I can understand your worries. First, it is of utmost importance to have a glass slide reviewed by a hematologist to check for the morphologic abnormalities, that is, the dysplastic features of the cells. Not only does it depend on the count, but also on the appearance of the cells that give the diagnosis of myelodysplasia. In your case, none of the absolute values of neutrophils, Hb, or platelets qualify for meeting the threshold criterion for MDS (myelodysplastic syndromes) (attachment removed to protect patient identity).
Hello, Welcome to icliniq.com. I have gone through the attachments (attachment removed to protect patient identity). Probable cause is cholecystitis. After reviewing your records, it is noticeable that there is persistent leukocytosis with prevailing neutrophilia and a slight microcytosis that is low MCV (mean corpuscular volume) and hypochromia that is low MCH (mean corpuscular hemoglobin) of RBC (red blood cells). Since your ferritin level is normal and no abnormal hemoglobin was detected, it is safe to rule out the presence of both iron deficiency anemia and thalassemia, which makes the aforementioned constellation indicative of a chronic infection, which may cause an impaired iron turnover as evident from the persistently low MCV and MCH.
Hello, Welcome to icliniq.com. I understand your concern. In case of a severe infection, an elevation of the white blood cell count (WBC) is expected, and it can reach up to 100 g/L, also described as a leukemoid reaction. This is not a blood cancer and denotes the presence of mature neutrophils on the peripheral smear due to the heightened demand for neutrophils to combat infection (as in your brother's case). Also, lymphopenia can be present in case of a viral infection with the appearance of so-called atypia or activation.
Hello,Welcome to icliniq.com.It would be uncommon to have clinically significant monocytopenia. However, the commonest reasons for monocyte deficiency are systemic lupus erythematosus (SLE) and intake of glucocorticoid medication. I have noticed that you are 22 years old and you are taking medication for elevated blood pressure; this itself is very concerning given your adolescence.Have you been checked thoroughly for the possible reasons for elevated blood pressure, such as kidney disease or elevated production of glucocorticoid hormones (which in turn may explain the monocytopenia)? On the other hand, the intake of Metoprolol in rare cases, such as 1/10000, can cause a decrease in WBC (white blood cell), affecting monocytes.
Hi, Welcome to icliniq.com. I have reviewed your results (attachment removed to protect patient identity). From what I have seen, leukocytes are within the normal range, as well as hemoglobin; platelets were not reported. From the automatic differential, there is indeed a slight lymphocytosis, but the manual differential (the one reviewed by the doctor under a microscope) reports 70 % neutrophils and 30 % lymphocytes. A mere laboratory result does not hold much strength, especially in your case, when the total leukocyte count is normal, and you report no other complaints such as malaise, night sweats, and/or fever.
Hello,Welcome to icliniq.com.Thank you for your query.I understand your concern. Myeloproliferative neoplasms (MPN) are a heterogeneous group of disorders of the hematopoietic stem cells. They can share a common genetic basis.
Hello,Welcome to icliniq.com.First, from what I see from the results (attachment removed to protect patient identity), there is the presence of low T3 and T4 levels with elevated TSH at the same time. It means that your thyroid function is deprived again and you need to restart hormone replacement therapy. The fact that your lipid levels are elevated speaks in favor of slowed metabolism and can be attributed to the current hypothyroid state.Second, your platelets are borderline.
Hi, Welcome to icliniq.com. Your condition requires a definite verification with a biopsy of a lymph node in order to exclude the presence of lymphoma. A case of generalized enlarged lymph nodes is always very concerning. I would advise you to undergo a biopsy test for sure, regardless of the CT scan results. In the case of lymphoma, changes in blood tests are present in already very advanced stages, which is why they are not reliable for diagnosis.
Hello, Welcome to icliniq.com. It is essential to know the primary reason for vitamin B12 testing. Was it done due to any complaints that could be related to anemia like fatigue, malaise, or any other symptoms that could be related to thrombotic complications possibly due to the inherited MTHFR (methylenetetrahydrofolate reductase) mutation? With the inherited MTHFR mutation, it is safe to maintain optimal levels of vitamin B12 rather than the lower ones. However, elevated levels of vitamin B12 and slight leukopenia associated with neutropenia should prompt further testing to exclude myelodysplastic syndrome. A review of the peripheral blood smear by a hematologist or a hematopathologist is advisable together with a comprehensive review of your primary complaints and complete blood count values.
Hello, Welcome to icliniq.com. I have reviewed your test results. Other than neutrophil count and folate levels, there is nothing worrisome. Given the fact that you have no symptoms (more specifically fatigue, night sweats, appetite, and weight loss), the low neutrophil count might be either constitutional or might be attributed to low folate, or if you take certain medications such as Paracetamol, might be due to its bone marrow suppressive effect. I would suggest a short trial with folate supplement and another CBC after a month.
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