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What Do These Ultrasound Report, CBC Test And LFT Reports Indicate?

Posted on Thu, 9 Jun 2016

Question: Hi Doctor,

During health checkup of my mother , aged 57 years old, following observations were done ( I am quoting only abnormal results). Rest were normal.

Ultrasound - mild spleen enlarged - 13 cm.

CBC WITH PERIPHERERAL SMEAR, ESR AND EDTA -

Haemoglobin 11.4 range - 12-15
MCH 25.8 range 27-32
MCHC 30.6 range 31.5- 34.5
RDW - 17 range 11.6 - 14

LYMPHOCYTES - 17.4 range 20-40

ESR ( WESTERGREEN) -22, range <20

Blood picture :
rbc - normocytic normochromic
wbc - count within normal range
platelet adequate

LFT :
ALKALINE PHOSPHATASE 148 range 40-129
GGT 6 range 8 -37

She is on diabetes medicine Jalra M and tyhronorm 50. Her sugar level is well within control.Her physical condition is good. no fever, loss of weight, or any abnormal symptoms.

I am worried with these findings. Is there something that needs to be done here. Please help.

Regards,

XXXXX

Answered by Dr. Abhijit Sonawane (2 hours later)

Brief Answer:
kindly read ahead

Detailed Answer:
Hello XXXXXXX
Thanks for posting in HCM.
I went through the report you posted and found that in summary she has mild splenomegaly, slighty less hemoglobin of 11 and slightly raised alkaline phosphatase.
If compared to clinical state of patient as you told that she is asymptomatic, then these findings are inconclusive.
Usually if patient has malaria or typhoid or any other acute infection then these values would have been expected but that is not the case here.
Neither the medications you mentioned have any kind of these adverse effects.
It could also mean that it could be some connective tissue disorder like SLE or other but these values are not evident enough to say that too.

I would like to advice you for now that if she is not having any complaints now, we can ignore these findings for time being and repeat these tests again after 1 or 2 weeks to see whether the values are showing any changes. If it consistently showing similar findings or raised we can think of excluding other conditions causing these.
Frankly speaking these values are very near to normal levels and should not be a reason for worry.
It is said in medicine that treat the patient and not the reports. So if she is fine then I feel we can wait and repeat the tests again to see any change.
So do not worry for now and we will see how it goes in future.
I hope I have answered your query satisfactorily.
If you have any questions kindly ask me back.
Thank you

Above answer was peer-reviewed by : Dr. Sonia Raina

Follow up: Dr. Abhijit Sonawane (54 minutes later)

Hi Doctor,

My worries, creep from internet, where I read the relation between enlarged spleen and leukemia. I do understand that she does not have any symptoms and her reports are very slightly abnormal. But is there anything that I might be missing here.

Thanks
XXXXX

Answered by Dr. Abhijit Sonawane (21 minutes later)

Brief Answer:
It cannot be leukemia. do not worry

Detailed Answer:
Hello XXXXXXX
Thanks for following up with me.

Yes, I agree that spleenomegaly can be seen in leukemia but there are so many other conditions which are not that serious but still can have spleenomegaly.
Leukemic blood picture is very different from what her blood reports are seen. They are not even close by.
So, this blood picture is no where nearby leukemia and you need not worry for the same.
As I mentioned in earlier reply that we will repeat the reports after say 15 days and we will see for any changes.
Come back again if you do the reports and let me see them so we will take it from there.
For now don't worry about leukemia and all.
We will see the repeat report.

Hope this advice is helpful.
If you have any questions kindly ask me back will be happy to answer them.
Thank you

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Above answer was peer-reviewed by : Dr. Deepak