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Have shortness of breath, dysautonomia and Lupus. Chest X-ray normal. Had other lab test. Findings?

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Practicing since : 2009
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Was seen at ER for Shortness of Breath. I have dysautonomia (POTS ) and Lupus . CHest xray was clear everything was normal except following labs:

WBC- 4.2 (slightly low) is this a concern?!
RBC- 3.99 low
Hemaglobin- 10.8 low
HCT-33.2 low
RDW 16 -High

also showed Slight anisocytosis and slight poikilocytosis what is this > im getting scared

I have lupus. and Dysautonomia
I want to add the rest of my labs

HCT 33.2 Low
MCV 83.2
MCH 27
MCHC 32.5
RDW 16
Platlets 272
MPV 8.0
Lymph % 38.9
Mono % 8.1
Seg 53.0
Lymph count 1.6 x 1000
Mono COunt
0.3x1000

Seg count 2.2x1000


could I have leukemia or lymphoma ? im worried about blood Cancer
Posted Mon, 23 Sep 2013 in Blood Disorders
 
 
Answered by Dr. Chobufo Ditah 3 hours later
Brief Answer:
Not cnsistent with lympoma/leukemia

Detailed Answer:
Hi and thank you so much for this query.

I am so sorry to hear about this recent ER visit and these "abnormal" findings that clearly have been disturbing to you. Let us address them.

From the information you have provided, there is nothing suggestive of lymphoma or leukemia. Please, be relaxed and understand this is not a possibility at this time.

Your findings all suggest the various counts being on the low side. This is consistent with the side effects of plaquenil which causes aplastic anemia(low cell counts). This explains why you have these findings alongside anisocytosis(varying sizes and this explains the reasons for the increased RDW) and poikilocytosis(differrent shapes).

The best thing to do is to talk with your doctor who would probe further into plaquenil as the most likely explanation of these findings and consider modifying treatment if it becomes worse.

Hope this helps and addresses your query fully. Feel free to ask follow up questions if need be.
Thanks for using our services and hope you do enjoy them
Wish you good health.
Dr. Ditah, MD

Above answer was peer-reviewed by
 
Follow-up: Have shortness of breath, dysautonomia and Lupus. Chest X-ray normal. Had other lab test. Findings? 2 minutes later
Thank you SO much - I read into things so much and im not a doc and shouldnt lol. would Iron tablets help ? I was thinking of buying them OTC till I get in w/ the doc. the plaquenil helps me a lot so I dont want to be off it it persay
 
 
Answered by Dr. Chobufo Ditah 7 minutes later
Brief Answer:
Iron wouuld not help!

Detailed Answer:
Thanks.

I am happy to know you read so much into things. I encourage you to but always seek clarification from experts when in doubts!

These results don't show plaquenil helps you a lot then you may want to rather monitor blood parameters closely and only consider changing when you cannot do otherwise.

Hope you find this helpful and addresses your query. Feel free to ask more related questions if needed.
I wish you well.
Dr. Ditah, MD

Above answer was peer-reviewed by
 
Follow-up: Have shortness of breath, dysautonomia and Lupus. Chest X-ray normal. Had other lab test. Findings? 14 minutes later
IF plaquenil is causing my anemia. will I then have to stop it ? is there anything they can do to prevent that and me staying on Plaquenil , is this a danger?

I would dread if i had to stop it
 
 
Answered by Dr. Chobufo Ditah 30 minutes later
Brief Answer:
Right now, NO.

Detailed Answer:
There are no red flags that suggest discontinuing this medication at this time.

However, through regular monitoring we may one day need to consider doing so and in such a situation, we shall be proposing alternatives.

Also, taking just the minimal required dose to keep symptoms controlled would help reduce side effects as most of them as dose related.

Please,, remember that you need regular eye exams and blood tests to monitor the adverse effects of this drug.

Hope you find this helpful.
Wish you well.
Dr. Ditah, MD

Al
Above answer was peer-reviewed by
 
Follow-up: Have shortness of breath, dysautonomia and Lupus. Chest X-ray normal. Had other lab test. Findings? 4 minutes later
I go to the eye doctor every 6 months,
and my doctor does blood work every 3 months - is three months enough? I never showed signs of anemia until now. in July WBC were 7.2 Hemaglobin 12 Hematocrit 27 platlets 305 and even everything else on the CBC Was normal then
 
 
Answered by Dr. Chobufo Ditah 4 minutes later
Brief Answer:
This is fine

Detailed Answer:
I think your doctor is doing a great job.

For now, continue with the same plan.
Monitoring these abnormal findings would provide a better understanding.

All the best.
Dr. Ditah, MD
Above answer was peer-reviewed by
 
Follow-up: Have shortness of breath, dysautonomia and Lupus. Chest X-ray normal. Had other lab test. Findings? 0 minute later
thank you so much! have a wonderful day
 
 
Answered by Dr. Chobufo Ditah 18 minutes later
Brief Answer:
Thank you too.

Detailed Answer:
Thanks for having offered me the opportunity to address your query today.

I wish you well.

Dr. Ditah, MD
Above answer was peer-reviewed by
 
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