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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Does This Blood Report Indicate?

I am 43, 5 4 145 lbs. I was diagnosed with PCOS in 2008 and on Metformin and Spironolactone and iron. I have been struggling with my health ever since. I have heavy periods and have decided to have a hysterectomy and on wait list. I have, in the past year, had swollen lymph node in right inguinal area. It once was very big and swollen and sore but went away after 3 months. I have had it back now for over 6 months and it will not go away. I have noticed this coincides with flare ups of hemorrhoids and high stress levels. Since January I developed a lump in my left breast which becomes quite firm and sore mid cycle and almost but not quite gone at the end of my menstrual cycle. Here is my latest bloodwork : Hematology WBC 5.4 4.0 - 11.0 10*9/L RBC 4.30 3.50 - 5.00 10*12/L Hemoglobin L 111 115 - 160 g/L Hematocrit 0.36 0.35 - 0.47 L/L MCV 83 80 - 100 fL MCH L 25.8 27.0 - 34.0 pg MCHC L 312 315 - 365 g/L Platelet Count 308 150 - 400 10*9/L Differential Neutrophils 3.2 2.0 - 8.0 10*9/L Lymphocytes 1.6 1.0 - 4.0 10*9/L Monocytes 0.4 10*9/L Eosinophils 0.2 10*9/L Basophils 0.0 10*9/L Granulocytes Immature 0.0 10*9/L Consider iron deficiency, chronic disease or thalassemia trait. Biochemical Investigation of Anemias and Iron Overload Vitamin B12 215 156 - 698 pmol/L Note: New Methodology effective January 13, 2016 (Roche - Electrochemiluminescence) Interpretation: Serum B12 [Probability of symptomatic deficiency] 75-150 pmol/L moderate 150-220 pmol/L low 220 pmol/L rare Clinically significant B12 deficiency may occur with B12 levels in the normal range, particularly in elderly patients. Ferritin L 6 14 ug/L Interpretation: 15-49 ug/L-probable iron deficiency 50-100 ug/L-possible iron deficiency 100 ug/L-iron deficiency unlikely. If result is persistently 600 ug/L, consider test for iron overload (transferrin saturation). General Chemistry Hemoglobin A1c Results are pending ... Sodium 141 135 - 145 mmol/L Potassium 4.6 3.5 - 5.0 mmol/L Creatinine 82 45 - 90 umol/L Estimated GFR 76 59 mL/min/1.73sq.m EGFR =60 mL/min/1.73 sq.m Kidney function estimate based on assumption of a stable serum creatinine concentration: diet, drugs, pregnancy, clinical state and muscle mass can affect accuracy of the estimate. Urinary ACR may assist interpretation. I am a little concerned of the immature granulocytes in relation to my symptoms. Any thoughts? Heather
Tue, 31 Dec 2019
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General Surgeon 's  Response
Hello,

* Immature granulocytes can be a response to underlying low hemoglobin and B 12 (active form, though blood level is in the normal range ) with excess menses loss and altered homeostasis of the body response to the same.

* My guidelines would be hysterectomy at earliest, supplemental iron
with B 12 and regular evaluation of blood chemistry.

Hope I have answered your query. Let me know if I can assist you further.

Take care

Regards,
Dr. Bhagyesh V. Patel, General Surgeon
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What Does This Blood Report Indicate?

Hello, * Immature granulocytes can be a response to underlying low hemoglobin and B 12 (active form, though blood level is in the normal range ) with excess menses loss and altered homeostasis of the body response to the same. * My guidelines would be hysterectomy at earliest, supplemental iron with B 12 and regular evaluation of blood chemistry. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Bhagyesh V. Patel, General Surgeon