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Blood reports normal except WBC, low IGM plasma, high SSB. Concerned about Sjorgrens ?

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Oncologist
Practicing since : 2002
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OVER THE PAST 5 YEARS EVERYTHING IS TAKING A DIVE! (EXCEPT MCH AND MCV and RBC): HCT AUTO 42.5 TO 40.00 HGB 14.9 TO 13.6 MCH 31.7 TO 31.8 MCHC 35.1 TO 34.1 MCV 90.3 TO 93.3 PLATELETS 173 TO 121 RBC AUTO 4.71 TO 4.28 RDW BLOOD 12.6 TO 12.4 WBC AUTO 3.9 TO 4.4 EVEN THOUGH THEY ARE NOT IN RED FLAG AREA THEY ARE GOING DOWN AS I AGE NOW 52 (FEMALE) IGM PLASMA LOW 38, TPO 118.3 HIGH SSB AB EIA POS A XXXXXXX 1:320 (A) DNA DS AB 74(A) EBV NA IGG 8.1 AND EBV VCA IGG 8.1(A) VIT D 33 EVEN THOUGH WBC GOT A LITTLE BETTER IT'S STILL LOW. SHOULD I GET A SECOND OPINION BECAUSE NO ONE SEEMS CONCERNED. SAY I MAY HAVE SJORGRENS THOUGH
Posted Mon, 21 May 2012 in Blood Disorders
 
 
Answered by Dr. Robert Galamaga 10 hours later
Hello. Thank you for submitting your question. Your question is a good one and I will work on providing you with some information and recommendations regarding what is going on.

On review of your complete blood count I am not concerned if you have anything serious going on. You have adequate hemoglobin as well as platelets and white blood cell count which should not cause any problem with bleeding or infection. keep in mind also that there is some degree a fluctuation in laboratory values from time to time with each blood draw. I am not convinced that you have a gradually decreasing blood count at this time. We would need to see more long-term data over the next several years to see if that is the case.

The additional lab results which you have provided do indicate that you may have an underlying autoimmune process going on. This is something which should be brought to the attention of a specialist in the field of rheumatology. I rheumatologist can discuss this with you in greater detail and provide additional recommendations.

At this time from a hematology standpoint there is no indication for any type of intervention. As I stated a mild autoimmune process can sometimes depressed the blood counts a little bit. At this time we do not see any depression in those counts to a worrisome range. If they're continued to be a trend in the lower direction of your blood counts a hematology evaluation might be performed where I'll primary bone marrow disorder. I think what is going on is related to the autoimmune process.

Again I want to reassure you that I do not see anything worrisome going on right now. I do think these laboratory values need follow up over the next 6 to 12 months. If there is a continued trend then a further workup would be warranted.

I thank you again for submitting your question. I hope you found my response to be helpful and informative. If you have additional concerns I would be happy to discuss those with you as well.

Sincerely,

Dr. Robert
Above answer was peer-reviewed by
 
Follow-up: Blood reports normal except WBC, low IGM plasma, high SSB. Concerned about Sjorgrens ? 4 hours later
I forgot to tell you that I had inflammation taken out of my ear in surgery in the nasopharynx. It was benign but causing vertigo. Afterwards my vertigo stopped and I am still having a 24 hour buzz in ear since Dec of 2011. I think it was also caused by autoimmune disease. I read that a lack of Testocerone can cause Sjorgrens. I am planning on taking the Bio Hormones for Estrogen and Prog but adding in with a Dr. help the Testocerone at a later time. I have a hearing test scheduled and an ENT followup, but do you think it is possible that I have Menieres Disease?
also I want to mention that my voice box always hurts and it is hard to speak at my job. NO one can figure this one out but I am pretty sure the Sjorgrens causes dryness everywhere. My lymph nodes always hurt on neck and I was wondering since you specialize in Oncology if you think I could have Lymphoma. I have had lymph nodes also under my arms for 14 years-but ultra sound only shows lymph nodes.Just worried. Is there a test for Lymphoma by looking at the blood?Thank you though for letting me know my blood work is fine for now.
 
 
Answered by Dr. Robert Galamaga 20 hours later
Hello and thank you for your follow-up question.

Regarding your lymph nodes I would find it extremely unlikely that you have lymphoma. There are some blood tests which can be done including a complete blood count and if your blood count numbers are looking fine it is unlikely that there is active lymphoma. If there is active lymphoma is generally causes a significant drop in all of your blood counts and we do not see that in your case. I want to reassure you that you should not worry about this right now.

I suppose it is possible you could have a form of Menieres but this I also think is relatively unlikely. I think it is reasonable to discuss this with the ENT physician.

Regarding the soreness of your throat this certainly could be possibly related to dry mucosa which can be seen in certain autoimmune disorders. I think a rheumatologist would be able to shed some more light on this possibility.

Again I want to reassure you that I do not see anything really worrisome going on. You have some minor issues with your general health that I think you're the physicians may be able to help you with. Right now from a standpoint that I am seeing things there is no active cancer or lymphoma. You may have a mild autoimmune disorder which may be controlled with medication that the rheumatologist might be able to provide.

I thank you again for submitting your question. I hope you found my response to be helpful and informative. If you have any additional concern I would be happy to discuss that with you.

Sincerely,

Dr. Robert
Above answer was peer-reviewed by
 
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