HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

question-icon

My Wife Has Had An Increasing Number Of Wbc And

default
Posted on Tue, 16 Jun 2020
Question: My wife has had an increasing number of wbc and liver counts over a period of about 6 months. Her PCP ordered special bloodwork for next week but I am just trying to see what potential outcomes we could be looking at or possibilities at what could be causing this. Below are the test dates and exam numbers.
test dates: 11/25/19 , 3/9/20 , 5/22/20
wbc counts from start: 5.8, 7.1, 10.9
Abs neutrophils: 2.2, 2.8, 5.6
Abs lymph’s: 3.0, 3.6, 3.6
Abs monocytes: 0.4, 0.5, 1.0
Abs eos: 0.2, 0.2, 0.5
Abs basos: 0.1, 0.0, 0.1
Alkaline phosphate: 123, 126, 136
Billirubin: 0.2, 0.2, 0.4
AST: 19, 23, 22
ALT: 21, 24, 36
Her cholesterol has also been high but I doubt this has anything to do with it. She is 27 years old.Thank you.
default
Follow up: Dr. Indranil Ghosh (0 minute later)
My wife has had an increasing number of wbc and liver counts over a period of about 6 months. Her PCP ordered special bloodwork for next week but I am just trying to see what potential outcomes we could be looking at or possibilities at what could be causing this. Below are the test dates and exam numbers.
test dates: 11/25/19 , 3/9/20 , 5/22/20
wbc counts from start: 5.8, 7.1, 10.9
Abs neutrophils: 2.2, 2.8, 5.6
Abs lymph’s: 3.0, 3.6, 3.6
Abs monocytes: 0.4, 0.5, 1.0
Abs eos: 0.2, 0.2, 0.5
Abs basos: 0.1, 0.0, 0.1
Alkaline phosphate: 123, 126, 136
Billirubin: 0.2, 0.2, 0.4
AST: 19, 23, 22
ALT: 21, 24, 36
Her cholesterol has also been high but I doubt this has anything to do with it. She is 27 years old.Thank you.
default
Follow up: Dr. Indranil Ghosh (32 minutes later)
I attached her bloodwork labs. I tried uploading multiple times but I managed to label 3 of them: nov, March, and May Thank you.
default
Follow up: Dr. Indranil Ghosh (0 minute later)
I attached her bloodwork labs. I tried uploading multiple times but I managed to label 3 of them: nov, March, and May Thank you.
doctor
Answered by Dr. Indranil Ghosh (8 hours later)
Brief Answer:
It's nothing alarming

Detailed Answer:
Hi
Thanks for your query.

There is a slight rise of lymphocyte counts and resultant total WBC counts. But it's nothing alarming. This is certainly not some malignancy if that is what you are worried about.

Viral infections, new medications, chronic illnesses, all may give rise to elevated lymphocytes. We may have to exclude these one by one in her.

Liver enzymes are probably raised due to fatty liver, which is usually seen with high cholesterol and triglycerides and paradoxically, the drugs used to treat these conditions also give rise to high liver enzymes. The levels in her are quite within acceptable range.

So, overall I think there is nothing to worry. I am sure she is able to maintain recommended diet, exercise levels and body weight.

Hope this helps.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Indranil Ghosh (0 minute later)
Brief Answer:
It's nothing alarming

Detailed Answer:
Hi
Thanks for your query.

There is a slight rise of lymphocyte counts and resultant total WBC counts. But it's nothing alarming. This is certainly not some malignancy if that is what you are worried about.

Viral infections, new medications, chronic illnesses, all may give rise to elevated lymphocytes. We may have to exclude these one by one in her.

Liver enzymes are probably raised due to fatty liver, which is usually seen with high cholesterol and triglycerides and paradoxically, the drugs used to treat these conditions also give rise to high liver enzymes. The levels in her are quite within acceptable range.

So, overall I think there is nothing to worry. I am sure she is able to maintain recommended diet, exercise levels and body weight.

Hope this helps.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Indranil Ghosh (37 minutes later)
Thank you for your response doctor. She has not been sick other than the headaches she started getting in March so I think we can rule out a viral infection. She Has been on no medications this entire time so we can rule that out too. And she has never taken any meds for cholesterol. She recently gave birth to our daughter in November so her PCP has been waiting to see if it drops on its own. He ordered a follow up CBC and a tumor marker blood test in 2 weeks so we will know more then. But after ruling out all of the above what potential outcomes do you see? If there was malignancy, would these numbers suggest an early stage? Her sed rate is 30 which is on the high end so that concerns me too.
default
Follow up: Dr. Indranil Ghosh (0 minute later)
Thank you for your response doctor. She has not been sick other than the headaches she started getting in March so I think we can rule out a viral infection. She Has been on no medications this entire time so we can rule that out too. And she has never taken any meds for cholesterol. She recently gave birth to our daughter in November so her PCP has been waiting to see if it drops on its own. He ordered a follow up CBC and a tumor marker blood test in 2 weeks so we will know more then. But after ruling out all of the above what potential outcomes do you see? If there was malignancy, would these numbers suggest an early stage? Her sed rate is 30 which is on the high end so that concerns me too.
default
Follow up: Dr. Indranil Ghosh (8 minutes later)
The fact that these numbers have kept rising over this period of time is beyond concerning to me. I know they’re not huge increments but none the less they have increased. As far as diet she has been doing better now than ever before so this steady increase has me worried. Did you get a chance to review the bloodwork I uploaded? Is there anything else you see that we should monitor or be concerned about? Thank you.
default
Follow up: Dr. Indranil Ghosh (0 minute later)
The fact that these numbers have kept rising over this period of time is beyond concerning to me. I know they’re not huge increments but none the less they have increased. As far as diet she has been doing better now than ever before so this steady increase has me worried. Did you get a chance to review the bloodwork I uploaded? Is there anything else you see that we should monitor or be concerned about? Thank you.
doctor
Answered by Dr. Indranil Ghosh (1 hour later)
Brief Answer:
Still there are no alarm signs

Detailed Answer:
I have reviewed all the blood work, lymphocytes have risen a bit over time but it doesn't denote any malignancy, even in early stage. Malignant lymphocytosis usually rises at a much faster rate and blood smear will show atypical lymphocytes, not seen in her.

It can't be acute leukemia as growth is exponential in that and this is not the age for chronic lymphocytic leukemia. The counts do not fit the criteria for testing for chronic lymphocytic leukemia too.

Post childbirth sometimes ESR is high, nothing to be worried of.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Indranil Ghosh (0 minute later)
Brief Answer:
Still there are no alarm signs

Detailed Answer:
I have reviewed all the blood work, lymphocytes have risen a bit over time but it doesn't denote any malignancy, even in early stage. Malignant lymphocytosis usually rises at a much faster rate and blood smear will show atypical lymphocytes, not seen in her.

It can't be acute leukemia as growth is exponential in that and this is not the age for chronic lymphocytic leukemia. The counts do not fit the criteria for testing for chronic lymphocytic leukemia too.

Post childbirth sometimes ESR is high, nothing to be worried of.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Indranil Ghosh (6 hours later)
Thank you for your response. Yes I agree that leukemia does not seem likely. Since liver counts have risen Along with her wbc that Made me think there could be a problem there. As far as the liver goes, would you suggest an ultrasound be done? I read that when tumor marker tests are done an ultrasound Is also when an issue with the liver is suspected. What would be the next steps you would take if wbc and liver counts kept rising? Thank you.
default
Follow up: Dr. Indranil Ghosh (0 minute later)
Thank you for your response. Yes I agree that leukemia does not seem likely. Since liver counts have risen Along with her wbc that Made me think there could be a problem there. As far as the liver goes, would you suggest an ultrasound be done? I read that when tumor marker tests are done an ultrasound Is also when an issue with the liver is suspected. What would be the next steps you would take if wbc and liver counts kept rising? Thank you.
default
Follow up: Dr. Indranil Ghosh (12 minutes later)
I am also trying to think why her liver counts are steadily rising? Her liver is not lacerated, she does not have any hepatitis. And she has taken no medications. Could a fatty liver be the only cause or is there any other scenario you can think off?
default
Follow up: Dr. Indranil Ghosh (0 minute later)
I am also trying to think why her liver counts are steadily rising? Her liver is not lacerated, she does not have any hepatitis. And she has taken no medications. Could a fatty liver be the only cause or is there any other scenario you can think off?
doctor
Answered by Dr. Indranil Ghosh (4 hours later)
Brief Answer:
WBC and liver enzymes likely not related

Detailed Answer:
Fatty liver is the probable explanation for the liver enzymes. Doing an ultrasound is a good idea as that can confirm if fatty liver is there and also exclude other diseases.

I would not recommend any tumor markers for her case. They are unhelpful for evaluation of mild liver enzymes elevation.

The blood counts will need periodic monitoring only.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
doctor
Answered by Dr. Indranil Ghosh (0 minute later)
Brief Answer:
WBC and liver enzymes likely not related

Detailed Answer:
Fatty liver is the probable explanation for the liver enzymes. Doing an ultrasound is a good idea as that can confirm if fatty liver is there and also exclude other diseases.

I would not recommend any tumor markers for her case. They are unhelpful for evaluation of mild liver enzymes elevation.

The blood counts will need periodic monitoring only.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
default
Follow up: Dr. Indranil Ghosh (3 hours later)
Understood. Thank you for your time and assistance in this matter doctor. It’s greatly appreciated.
default
Follow up: Dr. Indranil Ghosh (0 minute later)
Understood. Thank you for your time and assistance in this matter doctor. It’s greatly appreciated.
default
Follow up: Dr. Indranil Ghosh (1 hour later)
My apologies doctor. One final question. I’ve been reading into non Hodgkin lymphoma and how increased numbers of alkaline phosphate along w/ a high count of alt or ast can indicate such cancer. Both alkaline phosphate and alt have risen in my wife”s case. In NHL what are these counts like? And should we further look into this possibility? Thank you.
default
Follow up: Dr. Indranil Ghosh (0 minute later)
My apologies doctor. One final question. I’ve been reading into non Hodgkin lymphoma and how increased numbers of alkaline phosphate along w/ a high count of alt or ast can indicate such cancer. Both alkaline phosphate and alt have risen in my wife”s case. In NHL what are these counts like? And should we further look into this possibility? Thank you.
doctor
Answered by Dr. Indranil Ghosh (4 hours later)
Brief Answer:
Very unlikely

Detailed Answer:
Non hodgkin lymphoma doesn't present in young patients with high lympocyte count or liver enzymes. High lympocyte count may be present sometimes in non hodgkin lymphoma but that's as in chronic lymphoyctic leukemia, ie in elderly patients.

Rarely, if lymphoma involves liver, liver enzymes can be high but patient has lot of symptoms in that situation like anorexia, weight loss, indigestion, etc.

Above answer was peer-reviewed by : Dr. Kampana
doctor
doctor
Answered by Dr. Indranil Ghosh (0 minute later)
Brief Answer:
Very unlikely

Detailed Answer:
Non hodgkin lymphoma doesn't present in young patients with high lympocyte count or liver enzymes. High lympocyte count may be present sometimes in non hodgkin lymphoma but that's as in chronic lymphoyctic leukemia, ie in elderly patients.

Rarely, if lymphoma involves liver, liver enzymes can be high but patient has lot of symptoms in that situation like anorexia, weight loss, indigestion, etc.

Above answer was peer-reviewed by : Dr. Kampana
doctor
default
Follow up: Dr. Indranil Ghosh (1 hour later)
Understood. Thank you for your time and help doctor.
default
Follow up: Dr. Indranil Ghosh (0 minute later)
Understood. Thank you for your time and help doctor.
doctor
Answered by Dr. Indranil Ghosh (48 minutes later)
Brief Answer:
You are welcome

Detailed Answer:
regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Indranil Ghosh (0 minute later)
Brief Answer:
You are welcome

Detailed Answer:
regards
Note: Do you have more questions on diagnosis or treatment of blood disorders? Ask An Expert/ Specialist Now

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Indranil Ghosh

Oncologist

Practicing since :2004

Answered : 1712 Questions

premium_optimized

The User accepted the expert's answer

Share on

Get personalised answers from verified doctor in minutes across 80+ specialties

159 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
My Wife Has Had An Increasing Number Of Wbc And

My wife has had an increasing number of wbc and liver counts over a period of about 6 months. Her PCP ordered special bloodwork for next week but I am just trying to see what potential outcomes we could be looking at or possibilities at what could be causing this. Below are the test dates and exam numbers. test dates: 11/25/19 , 3/9/20 , 5/22/20 wbc counts from start: 5.8, 7.1, 10.9 Abs neutrophils: 2.2, 2.8, 5.6 Abs lymph’s: 3.0, 3.6, 3.6 Abs monocytes: 0.4, 0.5, 1.0 Abs eos: 0.2, 0.2, 0.5 Abs basos: 0.1, 0.0, 0.1 Alkaline phosphate: 123, 126, 136 Billirubin: 0.2, 0.2, 0.4 AST: 19, 23, 22 ALT: 21, 24, 36 Her cholesterol has also been high but I doubt this has anything to do with it. She is 27 years old.Thank you.