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Have primary immunodeficiency disease. Blood test done. Should I go for a bone marrow biopsy?

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Allergist and Immunologist
Practicing since : 1999
Answered : 584 Questions
I am a 32 year old who has a Primary Immunodeficiency Disease. I have just received my clinic letter from my Immunologist (London, UK) and there is some information that goes way beyond my expertise. In the last few years we have been excluding Lymphoma due to me suffering from night sweats, Pruritus, Breathlessness and lymph nodes hurt when I drink alcohol. I am not due to see my Immunologist till early next year due to him been 4 hours away from where I live in the UK so if possible could you explain what all these numbers mean. One doctor has said the labs show some immature forms of white cells which could indicate a problem in the bone marrow and that I should get a bone marrow biopsy. I just want a second opinion so I could let my local consultant who deals with my infections knows the best course to take. Below are my blood results:-

Haemoglobin = 11.7 g/dl
White Cell Count = 5.85
Platelet Count = 360
MCV = 83.0 fL
Neutrophil Count = 2.76
Lymphocyte Count = 2.34
U&E's and LFT's = Within Normal Range
CRP = 14 mg/L - Comment: Elevated - Had a recent CRP 2 weeks ago which was 13 mg/L
LDH = 344 IU/L - Comment: Within Normal Range
Beta 2-microglobulin = 2.5 mg/L - Comment: Within Normal Range
Immunoglobulins - IgA = 0.5 g/L, IgG = 8.8 g/L, IgM = 0.8 g/L - Comment: Low IgA Level
Serum Protein Electrophoresis = No Paraprotein Detected

Immunodeficiency Panel

Lymphocyte Count = 2.565 x 10^9/L
CD3 Count = 2.117 x 10^9/L
CD4 Count = 1.504 x 10^9/L - Comment: Borderline elevated CD4 Count
CD8 Count = 0.700 x 10^9/L
CD19 Count = 0.204 x 10^9/L
CD56 Count = 0.201 x 10^9/L

CD19+ B Cells:- Naive B Cells = 83.34%, IgM Memory = 7.82%, Switched Memory = 4.70%, CD21-CD38- = 3.20%, Transitional B Cells = 5.78%, Plasmablasts = 0.19% - Comment: High Naive and Transitional B Cells. Low Switched Memory and Plasmablasts.
Tissue Autoantibody Screen = Negative

Kind Regards
Posted Sat, 3 Nov 2012 in General Health
Answered by Dr. Sujoy Khan 15 hours later
I am sure your immunologist will explain all what these mean when you see him/her.
Overall, I do not see any result that would concern me apart from CRP being just a bit high while low IgA but NOT IgA deficiency (<0.01).
There are several causes of night sweats, and a thyroid panel would seem important in this setting.
Low switched memory B cells is not so important as your serum immunoglobulins are normal (apart from slightly low IgA).
If you are getting regular fevers with night sweats and palpable lymph nodes, a infections have been excluded.
My suggestion would not be a doctor (GP) to discuss this with the Immunology Lab.
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