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Have bone pain, Extreme tiredness and nausea. Done with blood test. Findings?

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Practicing since : 2002
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I do not know what these results mean... mild splenemogly, just below normal platelets at 89, positve evb igg but negative for ebv igm and negative on both for ab... retic just above normal at 2.3, and wbc with rare hypersegmented nuetrophil with few toxic cells.. I also have bone pain Extreme tiredness and now nausea...keep getting bounced from dr to dr. What does that lab report mean?
Posted Thu, 25 Jul 2013 in Blood Disorders
Answered by Dr. Robert Galamaga 10 hours later
Hello and thank you for sending your question.

I can appreciate that you have been dealing with a very challenging situation regarding your general health. From what you have described it is somewhat difficult to determine exactly what is the primary cause. I do have some thoughts however.

The mildly enlarged spleen may have nothing to do with what is going on. This might just be a slightly abnormal size of your spleen. At the same time sometimes, there can be situations where the spleen becomes active and causes changes in blood counts. This is especially true in the case of immune processes. In diseases sometimes, the spleen becomes activated and this can cause a decrease in the platelet count. Your platelet count is lower than normal but is not XXXXXXX at this time. Your doctors can do some blood tests to check to see if there is some type of autoimmune process that might be contributing to the low platelet count.

Regarding the EBV, you do not appear to have active viral infection so I do not think this is related to what you're dealing with.

The hypersegmented neutrophils can sometimes be found in situations of low vitamin B12 levels. This would be a simple test your doctor can check.

Regarding toxic granulations, we sometimes see this in situations of chronic infections. If you have history of chronic kidney stones sometimes, there can be chronic infections with bacteria that can cause this type of finding. This might also cause a low plate account. A complete urinalysis and urine culture might be advisable in this type of situation.

Regarding nausea and fatigue, again this is very difficult to determine. I would recommend you continue to discuss this with your doctor to try to find out what might be going on.

Thanks again for sending your question. I look forward to continuing to work with you to help optimize your health.

Dr Galamaga
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