Should I be prepared for any other tests to check my blood cell levels?

Question

Hi doctor,

I am a 35-year-old female. I have hypothyroidism and I am on Synthyroid. Overall, I am healthy. I exercise daily and do not smoke. I have a 15-month-old toddler. Throughout my pregnancy, my blood work showed an elevated WBC, but they are under 15000 per microliter of blood. They just assumed it was due to being pregnant. At six months postpartum, I noticed a lump on my neck. Further examination and ultrasound showed it was a thyroid nodule. FNA confirmed it was a follicular goiter, which is assumed to be benign. Follow up CBC blood work showed the following: WBC 15900 per microliter of blood, basophils 10%, IG 9.8%, absolute neutrophil count 8800 per microliter of blood, absolute basophils 160 per microliter of blood, IG ABS 1.65 g/L. All other counts were within the normal range.

I would like to add that I have had a persistent rather annoying headache for almost three months and have developed a weird itching. I itch like crazy and then when I scratch it, it leaves a red chaffed mark that is more than normal. I also feel rather fatigued, but have just assumed it was due to being a new mom. The only other thing I experience is a recurrent tibial stress fracture, which was around four times in 3.5 years. I cannot run more than 5 miles per week in good shoes on a soft surface without inflaming it. This is noteworthy because I have been a runner all of my life and it is a newer thing to me. I am going to meet my hematologist soon and I would like to know what to expect from my appointment. Should I be prepared for additional tests at my appointment? Thanks in advance.

Answer 1

Hi,

Welcome to icliniq.com.

Based on your query, my opinion is as follows:

The high basophil count of 10% associated with immature granulocytes of 9.8% is a bit worrisome.
The white blood cell count is unusually low for the above findings. As with the above, I expect to usually count on more than 100,000. It could be chronic myeloid leukemia or an allergic reaction.
Your tests may include bone marrow aspiration or biopsy along with mutation evaluation with tests like fluorescence in situ hybridization (FISH) to check for 9:21 or Philadelphia chromosome (abnormality in chromosome 22 of leukemia cancer cells).
I hope it is nothing and maybe some allergic reaction. You need to wait for the above tests, if your hematologist orders it.