Q. A 21 year old male fainted suddenly after a party. Please guide us.

Answered by
Dr. Parth R Goswami
and medically reviewed by iCliniq medical review team.
Published on Sep 09, 2018

Hello doctor,

This query is regarding a 21 year old male having no health complications in the past who suddenly fainted after a party. We took him to our GP for the check up. The GP found nothing wrong and advised rest. However, we went to the lab on our own and carried out CBC. WBC count was high in the first report - 11,300, lymphocytes 4,500, and RDW 16 which was indicated as high in the report.

The peripheral smear showed:

  • RBC: Normocytic normochromic with mild anisocytosis.
  • WBC: Absolute lymphocytic leucocytosis.
  • Platelets: Adequate.

We then went for one more blood test in the following week. This time the WBC was 7100 and lymphocytes 5100.

The morphology report says:

  • RBC: normocytic normochromic.
  • WBC: within normal limits.
  • Platelets: adequate on smear.
  • Impression: normal peripheral smear.
  • No hemoparasites seen.

The boy has lost some weight. A mild night sweat is there. Please guide us.

Dr. Parth R Goswami

Hematology Pathology


Welcome to icliniq.com.

The diagnosis in your case is lymphocytosis. The underlying cause for the lymphocytosis should be searched for. For that, a detailed physical examination should be done and liver, spleen and lymph nodes should be palpated. Infectious mononucleosis, viral influenza, hepatitis, lymphoproliferative disorders, syphilis, etc., are some of the causes.

If any specific clinical complaint is present than provide history regarding that for further discussion.

You investigate further according to need like influenza antibody testing, SGPT and SGOT, HIV testing, etc. Your peripheral smear examination reports are normal and are not showing any specific abnormal cells. You have to repeat CBC (complete blood count) again after a week.

If lymphocytosis persists for more than three to four weeks then flow cytometry investigation should be done to rule out monoclonal nature of lesion.

For more information consult a hematologist online --> https://www.icliniq.com/ask-a-doctor-online/hematologist

Thank you doctor,

Who can perform palpation of liver, spleen and lymph nodes? Our GP or someone else? Also, what is monoclonal nature of lesion?

Dr. Parth R Goswami

Hematology Pathology


Welcome back to icliniq.com.

Liver, spleen and lymph nodes palpation can be done by a general practitioner or physician. A physician would be the best doctor to consult in comparison to a general practitioner for a physical examination.

If no reactive cause for lymphocytosis is found, flow cytometry can be done to rule out monoclonal nature of the lesion. The monoclonal nature could be in the form of monoclonal B cell lymphocytosis or chronic lymphoid leukemia. The reactive lymphocytosis is polyclonal and not monoclonal that can be decided by flow cytometry. But practically speaking, at normal or low WBC count, a chance of reactive lymphocytosis is more as compared to leukemia or monoclonal B cell lymphocytosis. So, consult physician or hematologist for examination and if no specific secondary causes are found (like influenza, hepatitis, infectious mononucleosis, tuberculosis) than repeat CBC after a few days and if lymphocytosis is persistent then flow cytometry can be done.

For more information consult a hematologist online --> https://www.icliniq.com/ask-a-doctor-online/hematologist

Also Read Answers From:

Related Questions & Answers

We went for a regular check up and reports suggest leukemia. Can you help?

Query: Hello doctor,I went to the hospital for my father's normal check-up. He is 61 years old. His report looks like this: WBC 43000, platelets 1.2 L, and lymphocytes 88 %. To get it cross-checked, we went to another lab the next day and here are the counts: WBC: 38000 (Reduced by 5000), platelets 1.5 L (...  Read Full >>

Dr. Parth R Goswami
Family Physician, General Practitioner, Hematologist, Pathologist

Answer: Hello, Welcome to icliniq.com. Your father has absolute lymphocytosis. Repeat CBC (complete blood count) after one week along with complete peripheral smear examination to look for abnormal malignant cells like blasts. If the count does not come down, then investigate with flow cytometry examina...  Read Full

Is it true that gastric metaplasia is a precancerous lesion?

Query: Hi doctor, After testing positive for celiac disease, I had an EGD and biopsy three weeks ago. The pathology report stated that I had marked acute and chronic inflammation with severe reactive epithelial changes including villus blunting and gastric metaplasia. I was negative for H. pylori as I was ...  Read Full >>

Dr. Parth R Goswami
Family Physician, General Practitioner, Hematologist, Pathologist

Answer: Hi, Welcome to icliniq.com. Here according to your history, you were positive for gluten disease. So, you might have¬†done tissue transglutaminase antibody testing. It is very sensitive for that and then, a biopsy for confirmation. In histopathology report, villous blunting present but intra-epithel...  Read Full



Ask your health query to a doctor online?

Ask a Hematologist Now

* guaranteed answer within 4 hours.
Enter Your Health Query
You can upload files and images in the next step.



Disclaimer: All health Q&As published on this website is not intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek the advice from your physician or other qualified health-care providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website.