Dr. Goswami Parth Rajendragiri
Pathology
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Patient's Query
Hello doctor,
About a month ago, I did a CBC for a regular check up. It came back as elevated WBC and platelets. It was 16.3. Neutrophils absolute 11.8, lymph’s absolute 3.5, platelets 402. Everything else was in normal range. I have had it done twice and it stayed about the same. I recently did an abdominal CT scan and it was normal.
My doctor is going to do another CBC and if it is still elevated, she is going to send me to a specialist. I am extremely upset and worried. I have no symptoms. Does this mean I more than likely to have leukemia? I am a single mother and I am terrified. Could I please get a response?
Hello,
Welcome to icliniq.com.
Your platelet count is within normal limit. So do not worry about that. Your total count and neutrophils count is high. But your total count is not high enough to be labelled as leukemia. Usually such high count up to 20000 can be due to infection or any inflammation. So in such case, antibiotic course can be prescribed and repeated CBC after 10 days. However, if you can attach your reports then further comment can be given. Do not directly think about leukemia. In leukemia, total count is very high up to 1 lakh.
Patient's Query
Hi doctor,
Thank you for your response. What I attached is the latest CBC. I have done two within about two weeks. The first one was about the same. I suppose it really worries me because I do not have any signs or symptoms of infection. It feels like that is the only other thing or could be. I also have very extreme anxiety. I do not know if that could cause any elevation. Also, could you please explain the comment about the leukemia being high upto 1 lakh.
Hello,
Welcome back to icliniq.com.
In the case of leukemia, usually, the total WBC count is more than 50000 and up to 100,000 per microliter of blood. Your total WBC count is only 16000. Moreover, in leukemia, immature granulocytes or blast cells are also seen. In your CBC report, immature cells are not present (attachment removed to protect patient identity). So, considering overall CBC, finding the chance of leukemia seems very low. So you need not worry about leukemia.
If your liver and spleen are enlarged then we have to be alert or else not. The liver and spleen enlargement can be checked by USG abdomen scan or physical examination. However, it is advisable to repeat CBC with a peripheral smear examination report after 10 days. If still elevated then will do further work up. Revert back with repeat CBC and peripheral smear examination after 10 days. Do not worry about leukemia directly. You can consult a hematologist nearby for a physical examination if the total count is persistently elevated after ten days.
Patient's Query
Hi doctor,
Thank you for your reply. I did have a CT scan and my spleen and liver are normal. What else would it be if it is not leukemia? Could it possibly be a myeloproliferative disease like polycythemia?
Hi,
Welcome back to icliniq.com.
In polycythemia, hematocrit and hemoglobin value high. So, it cannot be polycythemia. Myeloproliferative neoplasm is part of leukemia. The chance of leukemia is very less in your case as your liver and spleen are also normal. Autoimmune disease, infection, inflammation, kidney disease, etc., can be different causes.
But after ten days, we will check the CBC and peripheral smear examination result again. If needed, then only I will suggest you to consult hematologist for detailed evaluation. Take care.
Patient's Query
Thank you doctor,
I got my CBC back today. My numbers look better but now I have a high monocyte absolute level that I have not had before of 1.0. I am not sure if this is slightly elevated or not. Is this something I should be worried about? I have attached the newest CBC count.
Hello,
Welcome back to icliniq.com.
Your total WBC count is decreased now and so your CBC result shows improvement. So, infection or inflammation might be the reason.The leukemia chance is very less. Your monocyte count is borderline.
After ten days, kindly repeat CBC. Do not repeat CBC again before 10 days of previous CBC. If after ten days, total WBC count is elevated, then you can consult nearby hematologist for your physical examination.
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Pathology
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