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Q. Please review my report about the carbon dioxide level in blood and eosinophilia.

Answered by
Dr. Muhammad Zubayer Alam
and medically reviewed by Dr. K Shobana
This is a premium question & answer published on Jul 31, 2021

Hi doctor,

I am concerned about carbon dioxide and the range of absolute eosinophils. Please review my laboratory report. Currently, I am under daily medication of HCT (Hydrochlorothiazide). Also, taking Vitamin D3 supplement daily and Vitamin C powder packs once a week.

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#

Hi,

Welcome to icliniq.com.

Thank you for the query. I can understand your concern. According to your statement, you have recently done some blood tests, and the investigation reports (attachment removed to protect the patient's identity) have revealed that your absolute eosinophils and blood carbon dioxide levels are high. Also, some other parameters are slightly higher or lower than the average level.

Raised absolute eosinophils count in blood is known as absolute eosinophilia. Absolute eosinophilia may result from some health conditions such as parasitic Infections, allergic reactions, drug reactions, any Infections, inflammation, or carcinoma.

Symptoms of Eosinophilia are itching, rashes, asthma, diarrhea due to parasitic infestations, runny nose due to allergies, etc. Your eosinophilia is mild because eosinophil count over 500 to 1500 cells/mcL is considered mild eosinophilia.

Also, your current medication, like tablet Hydrochlorothiazide may cause absolute eosinophilia, according to the research. Similarly, thiazide diuretics like Hydrochlorothiazide may also worsen carbon dioxide retention due to electrolyte imbalance and can cause raised carbon dioxide levels in the blood.

Again, one blood picture does not confirm anything. So, you can repeat these blood tests one month later. If you have no symptoms of eosinophilia, then there is nothing to be worried about at all.

Take care.

Hello doctor,

Thank you for the reply,

Abdominal ultrasound and grayscale imaging of the abdomen were performed in addition to color flow doppler evaluation of the hepatic and portal veins. The findings are as follows;

1) The liver is of average size and demonstrates a normal echotexture.

2) No biliary dilatation is seen within the liver.

3) The common bile duct measures 3 mm.

4) The gallbladder is remarkable for multiple sludge balls within the deep dependent portion of the gallbladder.

5) An echogenic swelling is present in the anterior wall measuring approximately 0.4 x 0.3 cm. It suggests a polyp.

6) The pancreas is limited in visualization due to bowel gas.

7) The right kidney is normal and non-hydronephrotic.

Impression obtained from the ultrasound is gallbladder sludge and polyposis. Also, doppler evaluation of the hepatic and portal veins demonstrates normal directional flow. Is there anything to be concerned about?

Thanks.

#

Hello,

Welcome back to icliniq.com.

Thank you for the query. According to your ultrasound report (attachment removed to protect the patient's identity), there is gallbladder sludge with polyposis.

Gallbladder sludge is composed of cholesterol, calcium, bilirubin, and other compounds. When bile remains in the gallbladder for too long, then gallbladder sludge is formed. Usually, gallbladder sludge is not a medical condition, and it can go away on its own without medical treatment.

However, in some cases, gallbladder sludge can develop complications like gallstones, pancreatitis, cholecystitis, blocked biliary ducts, etc.

Around 80% of patients with gallbladder sludge will not have symptoms. The rest, 20% of people may experience abdominal pain, nausea, vomiting, shoulder pain, chest pain or upper abdominal pain, passing of fatty stools during defecation, etc.

Lifestyle modification and some medications may help to subside gallbladder sludge. For example, avoiding alcohol consumption, restricting oily, fatty, and dairy foods, avoiding rapid weight gain or weight loss, etc., may help remove gallbladder sludge.

Again, I suggest Ursodeoxycholic acid to subside your gallbladder sludge. But, if you have pain associated with gallbladder sludge or it turns into gallbladder stones, then I suggest surgical interventions for gallbladder removal.

Take care.

Hello doctor,

Thank you for the reply.

Kindly look at my absolute eosinophil range and let me know the abnormalities in my eosinophil count.

Thanks.

#

Hi,

Welcome back to icliniq.com.

Thank you for joining again.

Eosinophil count above 500 to 1500 cells/mL is considered mild eosinophilia. So, the range above 572 cells/mL is regarded as mild absolute eosinophilia. Mild absolute eosinophilia may result from parasitic infestations, allergic reactions, medications, any infections or inflammations. The symptoms of eosinophilia are itching, rashes, asthma, diarrhea, and a runny nose. If you suffer from these types of clinical features, then you can take antihistamines. Your current medication, like Hydrochlorothiazide, may cause eosinophilia. I am unable to see your attached report here.

Take care.

Hello doctor,

Thank you for the reply.

Kindly look at the absolute eosinophil range on the attached report and tell me whether having an eosinophil range of 0.72 is higher or lower with 592 cells/mL on the other attached information. Two different laboratories are using different values and ranges. But both of them are out of range. I want to know whether it is normal to have such a range.

Thanks.

#

Hi,

Welcome back to icliniq.com.

Thank you for joining again.

According to the investigation reports (attachments removed to protect the patient’s identity), your absolute eosinophils count is 592 cells/mL in one investigation center, 0.72 k/mcL in another laboratory report. That is high indeed as the reference range is 0.05 to 0.45 k/mcL. After converting k/mcL to cells/mL, your absolute eosinophils count becomes 720 cells/mL. Both counts are high, and they indicate mild absolute eosinophilia.

Regards.

Hello doctor,

Thank you for the reply.

Even though it is mild, there is an increase in the eosinophil range. Should I need to consult a doctor and inform him?

Thanks.

#

Hi,

Welcome back to icliniq.com.

Thank you for the query.

I can understand your concern. According to your statement, you have recently done some investigations, and you want to know the interpretation of the results of those investigations. Your findings are non-specific. An ultrasound study shows an oval hypoechoic subcutaneous focus without vascularity or posterior shadowing 0.2 x 0.3 x 0.2 cm. It could represent resolving complex fluid collection such as hematoma.

The ultrasound shows a well-defined hypoechoic mass in the subcutaneous cellular tissue, which corresponds to a hematoma. A cyst is a pocket-like structure that contains liquid, solid or semisolid collections. In your case, your sebaceous cyst has a hematoma. Most often, sebaceous cysts disappear on their own over time. In some instances, incision and drainage with antibiotics coverage may be needed. It is not cancerous or a tumor. So, do not be worried at all.

In my previous answers, I have already mentioned the causes of eosinophilia. A sebaceous cyst can appear in any person, and it is very common. Your range is above average and indicates mild eosinophilia. Treatment depends on the causes. So, at first, the causes of your eosinophilia should be found out to treat it accordingly. Treatment options are stopping certain drugs, avoiding certain foods, taking anti-inflammatory or anti-infective medications in case of the presence of ongoing infections or inflammatory processes.

Take care.

Hello doctor,

Thank you for the reply.

If MID is a combination of eosinophils, monocytes, and basophils, how to know which one is elevated?

Thanks.

#

Hi,

Welcome back to icliniq.com.

Thank you for joining again. Yes, MID combines eosinophils, monocytes, basophils, blast cells, and immature cells. They are not classified as lymphocytes or granulocytes. Some automated blood cell counting analyzers can determine the relative size of the cells. They can only identify lymphocytes and neutrophils. These analyzers group everything that is not either neutrophils or lymphocytes into a category called MID. MID indicates combined values of other types of white blood cells (WBC). It just provides the essential information. If someone wants to know what kind of cells they are, they should look at the blood through a microscope to identify them.

As your blood test is done with such an analyzer, we could not differentiate all five basic WBC types. So it was able to identify only lymphocytes and neutrophils and identify other cells collectively as MID. As we already know that you are suffering from mild eosinophilia, we can tell your eosinophils count is raised among the cells of MID. But the exact count of your present eosinophils count cannot be identified.

Regards.

Hello doctor,

Thanks for the reply.

I had an ultrasound for the lump between armpit and arm (more towards the arm). Kindly review my report. Should I be worried? Is it cancerous?

Thanks.

#

Hi,

Welcome back to icliniq.com.

Thank you for the query. I can understand your concern. According to your statement, you have been suffering from a painless lump in the left axilla for the last three weeks. According to your ultrasound report, a subcutaneous essentially isoechoic oval finding measuring 3.5×0.8×2.4. cm and consistent with like a lipoma.

Lipoma is nothing but a soft, round, oval, or dome-shaped lump under the skin made of fat. It is not cancerous or does not cause cancer.

So, do not be worried at all.

Regards.

Hello doctor,

Thanks for the reply.

If I am diagnosed with May-Thurner Syndrome, is it safe to take the COVID vaccine?

Thanks.

#

Hi,

Welcome back to icliniq.com.

Thank you for the query.

I can understand your concern. May-Thurner syndrome is the vein narrowing that runs from the left leg to the large vein in the abdomen that leads to the heart. Symptoms of this disease are leg pain, swelling, blood clots, deep vein thrombosis, etc.

The COVID-19 (Coronavirus Disease-2019) vaccine may cause a blood clot in one in 1000 people. This complication can affect one person in 1000 people. According to the WHO's guidelines (World Health Organization), every person can get the COVID vaccine despite having clotting disorders. However, any person without May-Thurner syndrome can suffer from this complication. If the first dose of the COVID vaccine causes life-threatening allergic or anaphylactic reactions, the second dose of the COVID vaccine is contraindicated for such types of patients.

Take care.

Hello doctor,.

Thanks for the reply.

I was tested positive for COVID-19. The only sysmptoms I have is a slight cough and muscle aches. Can I take Cyclobenzaprine for the muscle aches?

Thanks.

#

Hi,

Welcome back to icliniq.com.

Thank you for the query.

I can understand your concern.

According to your statement, you have been suffering from cough and muscle aches due to COVID-19 infection. Cyclobenzaprine belongs to the group of medications known as muscle relaxants. It blocks pain sensations that are transmitted to the brain. And it is used in the treatment of muscle pain, stiffness, or discomfort.

On the other hand, COVID-19 infections mainly affect the respiratory system. It may cause respiratory suppression by relaxing the respiratory muscles. In the case of classical COVID-19 diseases, it may cause dry cough at first; then, after a few days, the cough may become intractable and eventually develop COVID pneumonia.

So, I think you should not take muscle relaxants like Cyclobenzaprine when suffering from COVID-19 infection. Using Cyclobenzaprine during COVID-19 Infections may increase the risk of developing respiratory suppression and severe breathing problems.

Regards.

Hello doctor,

Thanks for the reply.

I have a spirometer. Is it good to use the spirometer through out the day to keep my lungs well?

Thanks.

#

Hi,

Welcome back to icliniq.com.

Thank you for joining again.

By using the spirometer every two hours, you can keep your lungs active and healthy. It improves your ability to breathe and increases your lung capacity. It can reduce the risk of developing respiratory complications like bronchospasm or pneumonia. It can help to inform you about your lung condition and the volume of breath. You should monitor your oxygen saturation level by pulse oximeter routinely. If your oxygen saturation level declines below 90%, then you should get yourself admitted into the hospital for oxygen therapy.

Regards.

Hello doctor,

Thanks for the reply.

In my place, they used Regeneron antibody infusions for my recent COVID infections. I am thinking about taking it. What do you think about this?

Thanks.

#

Hi,

Welcome back to icliniq.com.

Thank you for joining again. Regeneron's antibody infusion (REGN-COV) can enhance the body's immune response, reduce viral load, and subside the associated symptoms in COVID-19 patients. The FDA (Food and Drug Administration) has granted an emergency use authorization to treat mild to moderate COVID-19 infections in adults and children above 12 years old. Regards.

Hello doctor,

Thanks for your reply.

Is there a peak period for experiencing COVID-19 severe symptoms after a positive test? I think my symptoms started four days back, and I was tested positive a day ago. I feel fine and do not have any temperature. Thanks.

#

Hi,

Welcome back to icliniq.com.

Thank you for joining again. I think you are pretty well now as two to three days have gone by already. It is a viral infection. In the case of viral infection, it is tough to predict anything. There is no certain peak period of experiencing COVID-19 infection. Any COVID-19 infected patient can become critically serious at any time. Four to nine days after being infected by COVID-19 disease is the high time for developing COVID pneumonia. If your cough becomes worse or in case of developing any respiratory complications, you can undergo HRCT (high-resolution computed tomography) of the chest to exclude COVID-19 pneumonia. Take care.


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