HomeAnswersHematologywhite blood cellsI have low white blood count and elevated lymphocytes. What may be the reason?

What may be the reason for low white blood count and elevated lymphocytes?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. Infanteena Marily F.

Published At March 25, 2022
Reviewed AtJanuary 4, 2024

Patient's Query

Hi doctor,

I have low white blood count for a year and elevated lymphocytes. I was under Metoprolol medication for six months and stopped it two months ago. I am also being treated for enlarged cervical lymph nodes. What may be the reason?

Thank you.

Hello,

Welcome to icliniq.com.

Following is my opinion for your asked question.

In your attached reports (attachment removed to protect the patient's identity), the only notable finding is mild leukopenia, which means low white blood cell (WBC) count. There are many causes for low WBC count like an autoimmune disorder, cancer, infections like HIV (human immunodeficiency virus) and TB (tuberculosis), etc. But sometimes, without any apparent cause also, the WBC count can come low. In the attached report, lymphocytes count was also normal. You might have a temporary infection or inflammation which has suppressed the bone marrow, thus, reflecting a low WBC count. All other parameters are within the limit. So you need not worry about a low WBC count. Your peripheral smear also shows normal white blood cells morphology. So there is no possibility of cancer as well. I suggest you monitor your WBC count after a few weeks. If lymphocytes are increasing or if WBC count is going low, then flow cytometry (to analyze the chemical and physical characteristics of the cell) can be planned in the future. You can visit a nearby hematologist for your physical examination and discuss all these.

I hope I have answered your question. Let me know if you have more questions in mind.

Best regards.

Patient's Query

Hi doctor,

Thank you for the reply.

What are the findings on the RBC morphology and what does it all mean? I have attached some more test that was done.

Thank you.

Hello,

Welcome back to icliniq.com.

Following is my opinion on your questions. From the attached reports (attachment removed to protect the patient's identity), your red blood cells show anisopoikilocytosis and polychromasia.

Anisocytosis means variations in the size of red blood cells. Poikilocytosis means variations in the shape of red blood cells. These two findings have significant only when the hemoglobin level is low. Low hemoglobin is suggestive of anemia in which anisopoikilocytosis is increased. But in your case, hemoglobin level is average, so anisopoikilocytosis is not a matter of concern in your CBC (complete blood count). Polychromasia means a bluish tinge in red blood cells which is seen in the case of red blood cells destruction like hemolytic anemia. In your case, hemoglobin and LDH (lactate dehydrogenase) and retic count (reticulocyte count) are normal. So you can neglect polychromasia findings as well. Therefore, in your case, anisopoikilocytosis and polychromasia are not a matter of concern, and they do not suggest any dangerous hematological condition. Your hepatitis report is also negative. So you need not worry about hepatitis infection as well.

I hope I have answered your question. Let me know if I can assist you further.

Best regards.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Goswami Parth Rajendragiri
Dr. Goswami Parth Rajendragiri

Pathology

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