Does the absence of monocytes indicate an immune disorder?

Question

Hello doctor,

I had a blood test about 7 months ago as part of a regular checkup. The only abnormality was an absence of monocytes. Around 2 days ago, I again did a complete blood count at the same laboratory, and my WBC results were like this :

WBC- 5.8 K/uL (normal).

Neutrophil- 50 %.

Lymphocyte- 49 %.

Monocyte- 0 %.

Eosinophil- 1 %.

Again my monocyte is zero percent. I would like to know if this is serious. Is it related to some immune system deficiency? I had no symptoms and no urinary, gastrointestinal, or pulmonary infection. I had a canker sore in my mouth twice.

Answer 1

Hello,

Welcome to icliniq.com.

It would be uncommon to have clinically significant monocytopenia. However, the commonest reasons for monocyte deficiency are systemic lupus erythematosus (SLE) and intake of glucocorticoid medication. I have noticed that you are 22 years old and you are taking medication for elevated blood pressure; this itself is very concerning given your adolescence.

Have you been checked thoroughly for the possible reasons for elevated blood pressure, such as kidney disease or elevated production of glucocorticoid hormones (which in turn may explain the monocytopenia)? On the other hand, the intake of Metoprolol in rare cases, such as 1/10000, can cause a decrease in WBC (white blood cell), affecting monocytes.

If you are concerned, I would suggest a consultation with a hematologist who can examine your peripheral blood smear manually under a microscope and evaluate the presence or lack of monocytes. In combination with a general examination, this can reveal a good hint that there is a reason to be bothered by this sole laboratory value.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq. Thank you.