What can cause persistent lymphocytosis and a low A/G ratio?

Question

Hello doctor,

I have undergone some laboratory tests. I am trying to piece together the results to look toward a possible diagnosis. I have attached the metabolic panel and immunofixation reports, as well as the other tests. I was diagnosed with ovarian cancer.

Do you have any ideas what the problem could be?

Below are my test results:

Complete blood count: Slightly high lymphocyte count and slightly low neutrophil count, consistent findings for eight months on regular tests.
Slightly elevated calcium level.
Peripheral smear findings: Rouleaux formation.
The pathologist mentioned that the albumin and globulin ratio is borderline low, and the carbon dioxide level is borderline high on the metabolic panel.
Polyclonal gammopathy showed no monoclonal cells present, which probably rules out multiple myeloma.

I am usually very healthy with normal blood results. I would like to get to the bottom of this. Please advise what could possibly be the issue.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understood your concern.

I am not able to open the documents, including the metabolic panel and the CA (cancer antigen)-125 report. Please attach them again so that I can try once more to open them.

Tell me a little more about your ovarian and cervical cancer history, if you know it; the year of diagnosis, how it was detected; and what treatment you received.

No M‑band (monoclonal protein band) in immunofixation is good news. I am convinced at this moment that you do not have any myeloma. There are a few other tests to help us feel confident.

They are as follows:

Bence Jones protein urine test.
Urine immunofixation tests.
There is one advanced test that I do not recommend at this moment. I am sharing this because you are very thorough with your disease and should be aware. It is a serum-free light chain (SFLC) test. Again, I do not recommend this now.

For now, just have tests 1 and 2 done. The logic behind these tests is that myeloma can involve the kidneys, so we should check that as well. You do not have myeloma, so do not worry.

Regarding your lymphocyte count, I am not sure if you received radiation in the past, but I have seen patients experience this after radiation. As long as your total WBC (white blood cell) count is normal and your neutrophils are not extremely low, I am not concerned.

I am sorry that I do not have a clear answer for you. Unfortunately, this is sometimes how things are. But let us look on the bright side: none of your reports are concerning at the moment.

Kindly follow up if you have more doubts.

I hope this helps.

Thank you.