HomeAnswersHematologyhashimoto's thyroiditisCan Hashimoto's thyroiditis increase lymphocytes after hysterectomy?

Can Hashimoto's thyroiditis increase lymphocytes after hysterectomy?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At July 5, 2018
Reviewed AtJune 9, 2023

Patient's Query

Hi doctor,

I 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 are within normal range. I did anti-TPO and my result is 2.01 and the reference range is less than 5.6. My question for you is in 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 it out? I do not have any symptoms.

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 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 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 conditions. This could be an autoimmune disorder such as thyroiditis or viral infection.

The Probable causes

Viral infection

Investigations to be done

Abdominal ultrasound

Differential diagnosis

Autoimmune disorder

Patient's Query

Hi doctor,

Thanks a lot for a very professional answer.

So, please help me with the following concern. Three years back, I had the same laboratory results for four months and then all come to normal until the test which I sent to you. I had many thyroid problems and many symptoms like kidney problems, 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 thyroiditis and till now, all blood work was fine. So, finally, can I attribute all this issue of the blood to the thyroid? Is it possible? Or shall I consider a blood disorder and go for further investigation?

Hi,

Welcome back to icliniq.com.

I would rather say that your problems might be due to 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's 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.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Elina Angelova Beleva
Dr. Elina Angelova Beleva

Hematology

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