Q. Do I have persistent lymphocytosis?

Answered by
Dr. Parth R Goswami
and medically reviewed by Dr. Preetha J
This is a premium question & answer published on Nov 20, 2020

Hi doctor,

I have attached my reports. Please explain to me what it is? Do I have persistent lymphocytosis?

#

Hello,

Welcome to icliniq.com.

Following is my answer to your asked question. In the attached reports (attachment removed to protect patient identity), your lymphocytes count are repeatedly elevated. So it is suggestive of persistent lymphocytosis. You have EBV (Epstein- Barr virus) IgG (immunoglobulin G) positive in the attached report, so past infection with EBV might be responsible for elevated lymphocyte. ANA (Antinuclear antibody) can be falsely positive in infection as well. So you can repeat ANA now to check whether it is positive or not. Your latest attached report, however, shows normal lymphocyte count. Therefore, infective etiology seems more likely for elevated lymphocyte. I suggest you consult a physician once for physical examination and accordingly investigation. I hope I have answered your question. Let me know if I can assist you further.

Best regards.

Thank you, doctor, for your reply.

Could the past EBV virus still cause an elevation in lymphocytes level? Should I be worried about the CLL?

#

Hello,

Welcome back to icliniq.com.

Following is my answer to your follow-up question.

In your latest report attached, which was done two months back, the lymphocyte count is normal. Your lymphocyte was elevated in the past. So EBV could not be the cause for the elevated lymphocyte.

The second possibility is autoimmune disease due to positive ANA. But ANA could be falsely positive due to infection. So after 12 weeks, it should be repeated. Therefore, now you should repeat ANA testing to check whether it is positive or not.

CLL is a form of blood cancer in which total WBC (white blood cells) count is usually very high, like more than 1 Lakhs. The liver and spleen are enlarged in CLL. In CLL blood cancer, smudge cells are seen in the peripheral smear, which is not present in your case. Hence, CLL is very less likely as per history and attached reports.

However, as I suggest you repeat your CBC and ANA after few days. Meanwhile, consult a nearby doctor for physical examination as well. If still after a few days, lymphocytes are elevated, then for our mental satisfaction, we should investigate with flow cytometry for a lymphoproliferative disorder like CLL.

But, flow cytometry is a very expensive test. Hence, first, repeat with CBC and ANA. If lymphocytes are still elevated, then discuss with your doctor about planning for flow cytometry. I hope I have answered your question. Let me know if I can assist you further.

Best regards.


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