Q. Can Hashimoto's thyroiditis increase lymphocytes after hysterectomy?

Answered by
Dr. Elina Angelova Beleva
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jul 04, 2018

Hi doctor,

I have had a total thyroidectomy (TT) two years ago and on my pathology report of the thyroid, I have had mild thyroiditis, and I always have high lymphocytes. For one period of about a year, they were raising every month. My Tg and Abt within normal range. I did anti-TPO and my result is 2.01 and ref range is less than 5.6. My question for you is on my case can Hashimoto thyroiditis decrease neutrophilia and increase lymphocytes even after hysterectomy? Or shall I consider blood cancer and make the test to rule out. I do not have any symptoms.


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Welcome to icliniq.com.

I have reviewed your results (attachment removed to protect patient identity). From what I have seen leukocytes are within 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) report 70 % neutrophils and 30 % lymphocytes. A mere laboratory result does not hold much strength especially like in your case when the total leukocyte count is normal and you report no other complaints such as malaise, night sweats and/or fever. However, if you have a concomitant enlarged lymph node and/or spleen to proceed with more specific tests such as flow cytometry to rule out chronic lymphocytic leukemia. But, anyway, the manual differential would have shown the presence of atypical, abnormal cells. Since it does report no atypia, this means that it is much less likely that there is a blood disorder (provided that no lymph nodes and spleen are enlarged and you have no complaints). I would suggest a regular, monthly blood count and differential tests and an abdominal sonography to check for the spleen. The changes in the blood counts can be just reactive to some condition. This could be autoimmune disorder such as thyroiditis or viral infection.

The Probable causes:

Viral infection

Investigations to be done:

Abdominal ultrasound

Differential diagnosis:

Autoimmune disorder

Regarding follow up:

For more information consult a hematologist online.--->https://www.icliniq.com/ask-a-doctor-online/hematologist

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Hi doctor,

Thanks a lot for a very professional answer. So, please help me to the following concern. Three years back, I have had the same lab results for four months and then all come to normal until the test which I sent it to you. I had many thyroid problem and many symptoms like kidney problem, many infarctions, bone pain, etc., for six months and when I removed I discover in the pathology report on thyroidectomy a year back. I found that I have the thyroiditis and till now, all blood work was fine. So, finally, can I attribute all this issue of the blood to thyroid. Is it possible? Or shall I more consider blood disorder and go for further investigation.



Welcome back to icliniq.com.

I would rather say that your problems might be due to the thyroiditis and a reflection of a general autoimmune reactiveness of your body. I would suggest that you have every six months check of TSH, anti-thyroglobulin and anti-TPO antibodies as well as a complete blood count. One autoimmune disorder usually goes with another. Meaning, if you might have Hashimoto thyroiditis, there is a high chance that you might develop pernicious anemia, which is an autoimmune related gastritis, causing anemia. Therefore a gastroscopy is more relevant in your case as well as abdominal ultrasound.

For more information consult a hematologist online --> https://www.icliniq.com/ask-a-doctor-online/hematologist

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