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What does my complete blood count results mean?

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Posted on Tue, 15 Jul 2014
Question: Can you please take a look at my CBC results and advise what they mean? Everytime I get my results my doctor tells me to rest in 3 months or in a month. This has been going on for over a year now. My WBC is continually low and as is my hemoglobin and other components of my blood. I am experience extreme hair loss and other symptoms. I need to know what is going on and what my blood tests reveal. Also, what other tests should I recommend as follow up to the copius CBC tests I have taken?

Thank you! RESULTS ARE BELOW:

Component     Your Value     Standard Range     Units
WBC      3.3      3.4 - 10.8     x10E3/uL
RBC      4.16      3.77 - 5.28     x10E6/uL
Hemoglobin      10.8      11.1 - 15.9     g/dL
Hematocrit      34.4      34.4- 46.6     %
MCV      83      79 - 97     fL
MCH      26.0      26.6 - 33.0     pg
MCHC      31.4      31.5 - 35.7     g/dL
RDW      16.8      12.3 - 15.4     %
Platelets      218      155 - 379      x10E3/uL
**Effective XXXXXXX 16, 2014, the reference interval**
for Platelets will be changing for 13 years and
older to: 150 - 379
LabCorp Problem Neutrophils     35      40 - 74     %
LabCorp Problem Lymphs      56      14 - 46     %
LabCorp Problem Monocytes     6      4 - 12     %
LabCorp Problem Eos      3     0 - 5     %
LabCorp Problem Basos     0     0 - 3     %
Neutrophils Absolute     1.2      1.4 - 7.0     x10E3/uL
Lymphocytes Absolute     1.8      0.7 - 3.1     x10E3/uL
Monocytes Absolute     0.2     0.1 - 0.9     x10E3/uL
Eosinophils Absolute     0.1     0.0 - 0.4     x10E3/uL
Basophils Absolute     0.0     0.0 - 0.2     x10E3/uL
LabCorp Problem Immature Granulocytes     0     0 - 2     %
LabCorp Problem Immature Grans (Abs)     0.0     0.0 - 0.1     x10E3/uL
doctor
Answered by Dr. Shruti Rijhwani (19 minutes later)
Brief Answer:
Need more testing...

Detailed Answer:
Dear Madam ,

Well, based on your reports, I see you are having microcytic hypochromic anemia. One of the most common cause is iron deficiency anemia. However since you didn't respond well with iron supplements, there is a need to look for other causes. I hope the blood counts are repeated after iron supplementation. If yes, it is necessary to rule out thalesemia. I order for Hb elctrophoresis as the first test in such case.

Rest since your WBC count is also in the lower range it will be good if you get a Vitamin B 12 levels , Thyroid fuction tests , peripheral smear for comment and ANA levels to see for any other alternate cause .

A bone marrow biopsy will be recommended if these tests are not able to yield anything. Keep in touch with your hematologist and discuss these options with him .

Take care.

Dr. Shruti


Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Shruti Rijhwani (36 minutes later)
Thank you for your detailed response. I have not been referred to a hematologist, should I request that?
doctor
Answered by Dr. Shruti Rijhwani (8 hours later)
Brief Answer:
Follows.

Detailed Answer:
Dear Madam ,

Since you are not showing improvement with the already prescribed treatment there is a need to investigate further plus your low WBC is more worrying factor so , yes a hematologist must see the case.

Dr. Shruti
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shruti Rijhwani (20 minutes later)
Thank you! I have made the request and discussed the additional testing with my primary care physician. Since I have to obtain approval for the referral, she is going to order the tests in the interim. When the results are in, do you mind if I follow up with you for your expert opinion?
doctor
Answered by Dr. Shruti Rijhwani (1 hour later)
Brief Answer:
Follows.

Detailed Answer:
Dear Madam,

I am highly obliged by your gesture , you can follow up with me , am not an expert on it but try to guide and help you out every possible way .

Dr. Shruti
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shruti Rijhwani (4 days later)
Hi Dr. Rijhwani,

You assisted me the other night with the interpretation of my blood test results. Per your direction, I requested the follow-up testing with my PCP. One of the test she ordered was the ANA w/Reflex if positive. Based upon my results, the doctor is referring me to a Rheumatologist, which coincidentally happens to be your specialty. I was wondering if you could take a look at my results and let me know what they mean specifically. I really want to thank you for your advice, but for me asking for the specific tests you requested I think I would still be where I was without my care being escalated.

The test results are as follows:
Component     Your Value     Standard Range     Units
ANA      Positive      Negative     
ds DNA Ab      154      0 - 9     IU/mL
Negative <5
Equivocal 5 - 9
Positive >9
RNP ANTIBODIES     <0.2     0.0 - 0.9     AI XXXXXXX ANTIBODIES     <0.2     0.0 - 0.9     AI
Antibody Screen     <0.2     0.0 - 0.9     AI
Anti-SS-A     0.2     0.0 - 0.9     AI
Anti-SS-B     <0.2     0.0 - 0.9     AI
Antichromatin IgG, Antibodies     <0.2     0.0 - 0.9     AI
Anti JO-1     <0.2     0.0 - 0.9     AI
Centromere Ab Screen     <0.2     0.0 - 0.9     AI
See below:     Comment          
Autoantibody Disease Association
------------------------------------------------------------
Condition Frequency
--------------------- ------------------------ ---------
Antinuclear Antibody, SLE, mixed connective
Direct (ANA-D) tissue diseases
--------------------- ------------------------ ---------
dsDNA SLE 40 - 60%
--------------------- ------------------------ ---------
Chromatin Drug induced SLE 90%
SLE 48 - 97%
--------------------- ------------------------ ---------
SSA (Ro) SLE 25 - 35%
Sjogren's Syndrome 40 - 70%
Neonatal Lupus 100%
--------------------- ------------------------ ---------
SSB (La) SLE 10%
Sjogren's Syndrome 30%
--------------------- ----------------------- ---------
Sm (anti-Smith) SLE 15 - 30%
--------------------- ----------------------- ---------
RNP Mixed Connective Tissue
Disease 95%
(U1 nRNP, SLE 30 - 50%
anti-ribonucleoprotein) Polymyositis and/or
Dermatomyositis 20%
--------------------- ------------------------ ---------
Scl-70 (antiDNA Scleroderma (diffuse) 20 - 35%
topoisomerase) Crest 13%
--------------------- ------------------------ ---------
Jo-1 Polymyositis and/or
Dermatomyositis 20 - 40%
--------------------- ------------------------ ---------
Centromere B Scleroderma - Crest
variant 80%
doctor
Answered by Dr. Shruti Rijhwani (5 hours later)
Brief Answer:
Follows.

Detailed Answer:
Dear Madam,

Thank you for reverting back .

Well looking at your result there is a fair possibilty that you could be having SLE or Lupus and that can be causing bicytopenia . You ANA is positive and anti ds DNA is also very high which further supports the evidence .

You should undergo complement C3 and C4 testing , Serum albumin levels , Urine r/m to look for proteinuria and Anti Sm antigen testing .

You should not ignore this , get in touch with rheumatologist as soon as possible . Avoid sunlight and use sunscreen lotion spf > 30 when in sun .

Please let me know if you hae any history of spontamenous aborions , recurrent oral ulcration , photosensitivity or rashes on face .

Dr. Shruti
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shruti Rijhwani (3 hours later)
Ok, will do. My mother has discord lupus, has for some time. I am not sure if it is hereditary though,

I have to wait for the referral to be processed, so I am not sure how long it will be. We. had additional tests done and ALL my iron levels are low, should I still request to see the hematolgist?

Yes, I had one miscarriage 2.5 years ago, I was about 6 weeks and yes, I have had recurrent oral lacerations on my tongue, but they seemingly appeared after dentists appointments. I guess I made a wrong correlation.

Thank you so much, you have been a blessing. I believe your advice may have saved life. If I didn't request the tests you recommended, I may still be taking CBC Differential tests every other month.

Thank you!!!!!!!!!
doctor
Answered by Dr. Shruti Rijhwani (3 hours later)
Brief Answer:
Follows.

Detailed Answer:
Dear Madam,

Since your mother had lupus although you say discoid variety of it the chances of you having it is raised many times .

Since you had a miscarriage you should be screened for Antiphospholipid syndrome also . Tests like lupus anticoagulant assay , anticardiolipin antibody , anti beta 2 glycoprotein antibody to see for any evidence of thrombosis possibility in future.

A coombs test should also be done to see for autoimmune cause of anemia

Your rheumatologist will explain in detail regarding all these tests . Once you have these tests done get back to me with reports .

In the mean time if you have any queries or problem feel free to ask. I will be happy to help you out in every possible way .

Wish you good health.

Dr. Shruti
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Shruti Rijhwani (8 hours later)
Thank you Dr. XXXXXXX , I appreciate all of your help!
doctor
Answered by Dr. Shruti Rijhwani (6 hours later)
Brief Answer:
Follows.

Detailed Answer:
Dear Madam,

I would love to help you out and guide you to the right diagnosis and treatment as per my abilities.

Dr. Shruti
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shruti Rijhwani (2 days later)
I am still awaiting the referral, but I will send you periodic messages to ensure our discussion is not automatically closed. If it is, is there a way to contact you directly?
doctor
Answered by Dr. Shruti Rijhwani (3 days later)
Brief Answer:
Follows.

Detailed Answer:
Dear Madam,

Thanks for reverting back.

I think you can ask me a question directly also through this website so thats not an issue .

Dr. Shruti
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Dr. Shruti Rijhwani

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What does my complete blood count results mean?

Brief Answer: Need more testing... Detailed Answer: Dear Madam , Well, based on your reports, I see you are having microcytic hypochromic anemia. One of the most common cause is iron deficiency anemia. However since you didn't respond well with iron supplements, there is a need to look for other causes. I hope the blood counts are repeated after iron supplementation. If yes, it is necessary to rule out thalesemia. I order for Hb elctrophoresis as the first test in such case. Rest since your WBC count is also in the lower range it will be good if you get a Vitamin B 12 levels , Thyroid fuction tests , peripheral smear for comment and ANA levels to see for any other alternate cause . A bone marrow biopsy will be recommended if these tests are not able to yield anything. Keep in touch with your hematologist and discuss these options with him . Take care. Dr. Shruti