Is there anything of concern in my husband's blood test?

Question

Hello doctor,

My husband is 27 years old. He had blood tests every nine months, and the report is as follows: WBC 5800, RBC 5400, Hb 16.6, HCT 47, lymphocyte 46.8%, neutrophils 39.2%, monocytes 8.1%, eosinophils 5.3%, platelets 186000, basophils 0.6%, ALT 0.8, and LIC 0.2. Again, he had a blood test last week, and it showed WBC 5500, RBC 5100, Hb 15.5, HCT 46, lymphocytes 43%, neutrophils 41%, and platelets 155000. Sometimes, he complains of an itchy throat.

Please help.

Answer 1

Hello,

Welcome to icliniq.com.

I have reviewed all the details you provided. For a sore throat, I recommend gargling with Listerine mouthwash twice daily and taking a combination of Montelukast and Fexofenadine once daily in the morning for three days. Additionally, advise him to avoid consuming cold water, cool drinks, alcohol, and smoking if he has those habits. If he has a fever, it may be necessary to prescribe a course of antibiotics and perform a throat swab to rule out a strep infection.

There are two concerning findings in his other reports: persistent lymphocytosis (high lymphocyte count) and thrombocytopenia (low platelet count). Persistent lymphocytosis, with counts of 46% and 43%, is commonly seen in viral infections but should not persist for months. Therefore, I recommend consulting a doctor and conducting further investigations, such as a peripheral smear, to evaluate the cause. If the peripheral smear shows abnormal lymphocytes, immunophenotyping may be necessary to determine the underlying cause.

Thrombocytopenia, with platelet counts consistently in the low normal range, can be seen in viral fevers. However, if it persists for months, it may be associated with conditions like splenomegaly. An ultrasound of the abdomen can help assess for splenomegaly. Low platelet counts can also occur in cases of infection, ITP (idiopathic thrombocytopenic purpura), or space-occupying lesions in the bone marrow. I strongly advise consulting your doctor, who may recommend a referral to a hematologist based on the clinical findings.

I hope this helps.

Please feel free to reach out in case of further queries.

Thank you.