How to improve the reduced blood cell count after a COVID infection in my husband?

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I read your query and understood your concern. From the reports attached (attachment removed to protect the patient's identity), it is evident that hemoglobin, MCV (mean corpuscular volume), and RBC (red blood cell) values are below normal levels, indicative of iron deficiency anemia. To address this, I suggest taking iron tablets in the form of Ferrous Ascorbate. Additionally, a high lymphocyte count is observed, which commonly results from a viral infection, while the CRP (C-reactive protein) level is also elevated. Therefore I suggest arranging for a repeat complete blood count (CBC) after a few days to assess the total WBC (white blood cell) count. Furthermore, I suggest taking tests for high-sensitivity C-reactive protein (CRP) and lymphocyte count. Kindly provide the subsequent report after these tests for further evaluation. Treatment is unnecessary if the patient remains asymptomatic. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Hello,

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I read your query and understood your concern. From the reports attached (attachment removed to protect the patient's identity), there is an indication of iron deficiency anemia. Anemia can occasionally contribute to a low WBC count. I suggest you consult a hematologist in your vicinity to initiate treatment for iron deficiency, specifically using Ferrous Ascorbate. In most cases, viral infections tend to manifest with noticeable symptoms. To gain a clearer understanding of the situation, I suggest you undergo a follow-up CBC after a few days to monitor the WBC count. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

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I read your query and understood your concern. Typically, an improvement in the total WBC count requires at least one week. Therefore, I suggest repeating the test after a span of ten days. Based on the provided reports (attachment removed to protect the patient's identity), the peripheral smear indicates the absence of abnormal cells such as blast cells. This makes the likelihood of cancer less probable. In the meantime, I suggest you consult a hematologist in your vicinity for a thorough examination and to establish a plan for further management. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

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I read your query and understood your concern. WBC play a vital role in combating infections within our body. The typical range for WBC count is between 4000 and 11000. When the WBC count drops below 1500, there is an increased susceptibility to infections. Therefore, there is no need for undue concern. The peripheral smear report is also within normal parameters, indicating the absence of abnormalities in white blood cells. The underlying cause of low WBC count may occasionally remain unidentified. Nevertheless, I suggest you maintain regular follow-up with your hematologist for ongoing monitoring and guidance. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

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I read your query and understood your concern. Based on the information you provided, your persistent leukopenia (low WBC count) has endured even after one week. Typically, WBC count reduction due to infection reverts to normal within a month. To address this, I suggest repeating the CBC after a few days and meanwhile, continuing with the iron tablet. If, over the next few days, the WBC count remains low, I suggest undergoing more comprehensive investigations like bone marrow aspiration or flow cytometry after consulting your doctor. All blood cells are produced in the bone marrow. Hence, a bone marrow aspiration-like investigation would conclusively rule out any underlying abnormalities if present. However, bone marrow procedure is invasive, so I suggest waiting for a few weeks before pursuing it. Additionally, I suggest you undergo serum ANA (antinuclear antibodies) investigation to rule out autoimmune diseases. I suggest you discuss all these options with your hematologist. If everything else is within the norm, there is no need to be overly concerned about a low WBC count. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

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I read your query and understood your concern. I have reviewed the reports you have attached (attachment removed to protect the patient's identity). You can proceed with the regimen of iron and folic acid tablets, along with the Vitamin B12 injection. The LDH investigation is aimed at exploring hemolytic anemia. Considering the patient's overweight condition, non-alcoholic steatohepatitis is also being considered by the doctor. I suggest lifestyle adjustments and weight reduction measures for this concern. I also suggest an abdominal ultrasound to exclude this possibility. I suggest you adhere to the doctor's recommendations and arrange for the CBC test. If leukopenia does not show improvement or if symptoms arise, bone marrow investigation could be contemplated as a last resort. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

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I have reviewed your reports (attachment removed to protect the patient's identity). In the attached report, LDH (lactate dehydrogenase) value is not elevated. In the ultrasound report, mild fatty change is detected, which is not concerning. Therefore, you can exclude nonalcoholic steatohepatitis. Both reports do not show any abnormalities. Therefore, there is nothing to worry about. Hope this information has helped you. Kindly follow up if you have more doubts.

Thank you.

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I have reviewed the report you have attached (attachments removed to protect the patient's identity), your HPLC (high-performance liquid chromatography) report indicates no abnormalities, confirming the absence of hemoglobinopathy. Typically, enhancement in hemoglobin levels due to iron supplementation becomes noticeable within ten to 15 days. Over the course of a month, hemoglobin can increase by two to four grams. However, the leukopenia continues to persist. I suggest you discuss with your doctor regarding the potential of flow cytometry or bone marrow studies in a few weeks' time. This will help ascertain if the leukopenia remains consistent or becomes symptomatic. In the interim, should you develop a fever, I suggest consulting your doctor promptly. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

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I read your query and understood your concern. I would like to inform you that, mild leukopenia is a common occurrence in some individuals. However, when dealing with leukopenia, it is vital to explore all potential causes. Cancer seems less likely in your situation since the peripheral smear report is within normal parameters. Nonetheless, if leukopenia persists over a span of several weeks and is accompanied by symptoms, I suggest you consider undergoing a bone marrow aspiration. This procedure is conducted under local anesthesia and typically does not cause excessive pain. To address your concerns, I suggest you continue with the iron tablet regimen and subsequently consult your doctor to discuss the necessity of a bone marrow investigation. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Regards.

Hello,

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I read your query and understood your concern. Based on the information you provided, the overall white blood cell (WBC) count has shown an increase. Consequently, there is no longer a need for concern. Anisopoikilocyte refers to variations in the size and shape of red blood cells (RBC), which can be observed in cases of anemia. However, this finding is not a cause for worry. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

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I read your query and understood your concern. I have reviewed the reports you attached (attachments removed to protect the patient’s identity), the bone marrow biopsy report remains inconclusive without the immunohistochemistry assessment. Kindly forward the immunohistochemistry report once it becomes available. The FISH (fluorescence in situ hybridization) report does not indicate the likelihood of MDS (myelodysplastic syndromes). However, a negative FISH report does not entirely rule out MDS. This determination would require a clinical evaluation. I suggest he undergo CBC (complete blood count) and ferritin tests, and share the resulting reports. For parotid gland involvement, additional historical information is necessary. Could you provide details such as the duration, presence of pain, sudden size increase, and the size of the glands in centimeters? Any associated fever? I also suggest he undergo CRP (C-reactive protein), EBV (Epstein-Barr virus), and FNAC (fine-needle aspiration cytology) tests for the parotid gland to facilitate further evaluation. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

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I read your query and understood your concern. I have reviewed the reports you attached (attachments removed to protect the patient’s identity), It suggests bone marrow suppression following a viral infection. His iron levels are satisfactory. Focus should be on elevating his vitamin B12, Folic acid, and Pyridoxine levels. Bone marrow suppression might take months to even years to fully recover. During this period, I suggest he undergo monthly CBC follow-ups, provided there are no ongoing symptoms. As for the bone marrow fibrosis, it could potentially be attributed to an infectious or autoimmune process. As of now, there is no evidence pointing towards leukemia. I will be able to provide further guidance upon the arrival of the immuno histochemistry report. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

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I have reviewed the reports you attached (attachments removed to protect the patient’s identity), the results from the immuno histochemistry are indicative of a tumor, specifically lymphoma or leukemia. It is a low-grade B cell neoplasm, which generally presents a favorable prognosis. In my experience, a combination treatment involving Fludarabine, Rituximab, and Cyclophosphamide has given positive outcomes. The successful remission rates in my practice exceed 98 %. Nonetheless, I suggest you consult with a hematologist-oncologist to formulate a comprehensive treatment plan moving forward. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Hello,

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I suggest you follow up your hematologist's advice. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.