Dr. Goswami Parth Rajendragiri
Pathology
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Patient's Query
Hi doctor,
My wife is 30 years old, we have one child 2.3 years old and healthy. She was feeding the baby till two years of her age. During pregnancy TSH was 5.7 and taken medication, after pregnancy, TSH became normal, stopped the medication as advised by the doctor. During pregnancy, heel pain was there continuously with coccyx pain. We did MRI whole spine, and it was normal. For the last month, there is no heel pain but while getting up from bed in the morning, there is pain in both feet. She takes a few seconds to get up from bed in the morning only. She is taking Tayo 60k for seven weeks and one on a monthly basis. She feels very low energy throughout the day with mild body pains. We consulted the doctor (general physician) and advised CBC, TSH, vitamin D, and vitamin B12. I am attaching reports. TLC was 3.97, after one week it was 3.56. Platelet was 125 and after a week 158. As of now, I do not have any problems except weakness, or mild body pains. The patient's weight is 92 to 99 lbs for many years. During pregnancy, it is 116 lbs, and now it is 94 lbs. Height is 5 feet.
My query is regarding TLC count and platelet. If we need some more investigations? If there is any abnormality then how fast TLC can go down? What is the reason for low TLC? Does she need to consult someone else? If after three months TLC count will be the same, is it worrisome? If it is not going down or up, is it serious? Assuming it is the same for the next six months then what should I do?
Hi,
Welcome to icliniq.com.
Kindly find answers to your questions below. Your total leukocyte count and platelet were low initially. But gradually it has been improved so suggests recovery of any unnoticed infection. Moreover, the peripheral smear examination report was normal (attachment removed to protect patient identity) and not showing any abnormal cells that warrant further investigation. You have to still repeat CBC (complete blood count) after a few days. The TSH (thyroid stimulating hormone) is high, so hypothyroidism should be ruled out. For that repeat the TSH estimation after a few days and investigate with T3, and T4 estimation as well. If there is any abnormality, then gradually all counts go down or high, and a peripheral smear shows abnormal cells if blood cancer is present.
It is difficult to say one reason for low WBC (white blood cells). But the infection can be possible. If no cause is evident then ANA (antinuclear antibody) estimation can be done to do a work up for autoimmune disease. If your CBC values do not fall within the range in the next few days then a hematologist can be consulted for a detailed evaluation. If hypothyroidism is confirmed then Levothyroxine should be started.
Patient's Query
Hi doctor,
Thank you for the reply,
I had done my CBC yesterday and my TLC count is 3.56. So, when do you want me to repeat this again for CBC? CBC done 10 days back showed a TLC count of 3.97.
Hello,
Welcome back to icliniq.com.
Kindly repeat CBC after one week. Meanwhile, after seven to ten days repeat TSH and free T4 estimation as well. Your peripheral smear examination report is normal. So I am not suspecting any blood cancer-like dangerous condition just now.
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Pathology
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