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Suggest Treatment For High Monocyte Count And Leukopenia

Posted on Mon, 27 Feb 2017

Question: Hi, I have had neutronpenia/leukopenia for 12 months. I have recently become anemic and have had 2 iron transfusions. I also have high monocyte count 16.2% My B12 is high 2000, with 1200 being the high range. And my creatine clearance is always high, BUN high and Aklanine phosypatase low. After a year, my general practitioner is sending me to Stanford for a second opinion. My hematologist said this is just normal for me. Some people just have neutropenia and leukopenia and it's not a problem. But, I get severe bruising and extreme fatigue.

Answered by Dr. Deepak Sundriyal (40 minutes later)

Brief Answer:
You'd require further evaluation

Detailed Answer:
Hello dear. I have gone through the details.

So some people may have mild degree of neuteropenia but that is uncommon.. More common is disorders of blood like leukemia and myelodysplasia which needs to be ruled out by bone marrow examination and blood investigations.

Let me know if I can assist you further.

Thanks and regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Deepak Sundriyal (3 minutes later)

I have an appointment with Stanford next week. What makes you think I need further evaluation? Or possibly Leukemia and myelodysplasia?

Do you want to know my actual blood levels? or anything else? Does my chemical panel correspond to my possible blood cancer diagnosis?

Answered by Dr. Deepak Sundriyal (4 minutes later)

Brief Answer:
It may go either way

Detailed Answer:
Hello again dear.

It may go either way. Please upload your blood count reports here. Chemical panel will not lead to anything but is required. I can throw more light in to it after reviewing them.

Awaiting..

Thanks and regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Deepak Sundriyal (31 minutes later)

WBC 2.3 (4.8-10.8)
RBC 4.15 (4.2-5.4)
Hbg 11.8 (12-16)
Hematocrit 36.0% (37-47)
Monocyte 16.2%
Eosinophil 0.4%
Granulocytes/Bands/Blood 1.4%
Lymphocytes 0.6%

Vitamin B12 2000 (200-1100)

Iron Saturation 9% (20-50)
Iron Serum 27 (28-170)
Iron Binding Capacity 307 (250-450)
Ferritin 25.4 (6-115)

Alkaline Phosphatase 28 (42-121)
BUN/ Creatitine Ratio 33 (10-20)
Creatine Clearance 118.59 (75-115)

Those are my labs that seem to be off, plus some others that are normal.

I just don't know why I am so tired, and bruise so badly. It looks like I was in an accident or hit by a bat all over my legs.

Also, how did my hematologist know I was iron deficient? How do you know what kind of Anemia you have? Iron, Aplastic, Etc

Answered by Dr. Deepak Sundriyal (1 hour later)

Brief Answer:
Hello. It may be myelodysplasia

Detailed Answer:
Hello dear. I have gone through the details. So an elevated b12 can be seen in leukemia. You have low serum. Iron and transferrin saturation which points towards iron deficiency. You require a bone marrow test and a flow test to rule out leukemia. Bruising and tiredness are well known symptoms of cancer. Fatigue can be seen in anemia too.

Thanks and regards

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Deepak Sundriyal (7 minutes later)

Thank you. I am glad I am going to Stanford next week for a second opinion. This has been going on for a year

Answered by Dr. Deepak Sundriyal (2 minutes later)

Brief Answer:
Hello dear. Get yourself investigated

Detailed Answer:
Hello. Yes you must do hurry to get yourself evaluated. Please share the reports of bone marrow test so that i can through more light.
Thanks and 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. Yogesh D