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Have done with Blood test for CBC and ESR. What are the findings?

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General & Family Physician
Practicing since : 1978
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Doctor, pls find attached the blood test report done for CBC & ESR ( Password for the attached doc is YMRC0000) . could you pls let me know whats wrong with the report and where should I improve. Should I do any further tests for more details. Pls advice me.
Posted Sat, 29 Jun 2013 in Blood Disorders
Answered by Dr. Pavan Kumar Gupta 18 hours later
I have seen your reports and find that mainly your neutrophils are low and lymphocytes are high.Total white cell counts are also just below the normal range at 3800.
Basically this is not  in itself a disease but these reports indicate that something is wrong with the body and there is some underlying problem.

People with low neutrophils are more vulnerable to infections and other diseases and can be caused by decreased production of neutrophils or increase in destruction of neutrophils. 

Decreased production of neutrophils may result out of leukemia or aplastic anemia. Autoimmune diseases such as due to destruction of these cells. Other diseases and disorders accompanied by low neutrophils are rheumatoid arthritis, hepatitis, myelofibrosis, malaria, mononucleosis, sepsis, enlargement of the spleen, histoplasmosis, rubella, influenza, mumps, tuberculosis etc.

Drop in neutrophil count can also occur as a side effect of certain medications. These include chemotherapeutic medications, antibiotics, diuretics etc. Vitamin B12 or folic acid deficiency can also lead to low neutrophils.

Lymphocytes are also a type of white blood cells and chief constituents of the immune system. They are produced by the bone marrow.Under normal circumstances, the white blood cells contain some 15 to 40% of lymphocytes. If there is increase of lymphocytes over 40% of total amount of white blood cells this condition is known as high lymphocyte count or lymphocytosis. 

Different infections of the body may be the cause of lymphocytosis, especially chicken pox, rubella, mumps, toxoplasmosis and brucellosis (animal infections) or herpes simplex infection. Flu and whooping cough may also provoke increase in amount of lymphocytes present in the blood.

Acute and chronic lymphocytic leukemias (ALL and CLL) are also known to increase lymphocytes. Similarly Mononucleosis and various hepatitis or cytomegalovirus infections can also be blamed for increased amount of these white blood cells.
Diseases such as ulcerative colitis or inflammatory bowel disease (IBS) or Crohn’s disease can be the reasons behind increased number of these blood cells. Some of the other reasons that may be responsible for the raise of lymphocytes are inflammation of blood cells, some autoimmune disorders and plasma cell cancer like multiple myeloma.

What you require is detailed investigations to find out the cause for abnormality in your tests.You must consult a HEMATOLOGIST,who can get the further relevant investigations done.
I hope it helps however you may revert to me for any further query.
Best of luck
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