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What Does This Blood Report Indicate?
Question: I have been monitored for about 1 year for low wbc. 2.70 to 3.72. Last appt Sept 15th went to hematologist and my count was 2.96. He didnt seem concerned although he reviewed the role of a bone marrow with aspiration I'm assuming so the new dr. taking over would know. He said he did not see a reason to have one unless I wanted one to reassure me. But I said if you don't think I need one I'm not having one. Yesterday I went to ER for anxiety attack. they drew blood wbc 3.72, rbc 4.10, hcb 13.5,hct 39.4, mcv 96.1,mch 32.8,mchc 34.2,rdw sd 43.3,plt 302, mpv 7.9....diff types neutrophils 72.88, lymphocytes 13.92, monocytes 10.46, eosinophils 1.46, basophils 1.28, neutrophils abs 2.71, lymphocytes abs 0.52, monocytes abs 0.39, eosinophils abs 0.05, basophils abs 0.05. Dr said everything looked good at the er. Can you tell me please if I have anything to worry about? I also have MS and take an injection of Avonex and have been for 16 years but have been off the medicine for 5 months to see if that would raise my wbc count. Just worried and full of anxiety. Thanks XXXXXXX
Brief Answer:
Considerations
Detailed Answer:
hello and thank you for sending the question.
This type of situation is a very common reason for referral to hematologists. Your white blood cell count has been mildly decreased from the results you have shared with me. It is important to note that your hemoglobin and your platelet count are normal. This generally indicates that a primary process involving your bone marrow is unlikely. This could simply be an auto immune process that causes a mild decrease in your white blood cell count.
However, if this continues to cause you significant stress and anxiety I would recommend asking for the bone marrow biopsy which would help to completely rule out any issue with your bone marrow that could cause low white blood cell count.
I assume that your doctors have checked other labs including vitamin B 12 and folic acid levels which can sometimes contribute to a low white blood cell count.
Again I do not suspect that you have anything like leukemia or lymphoma but if you would like the extra level of reassurance then a bone marrow biopsy would be worthwhile.
Thanks again for sending your question.
Sincerely,
Dr. Galamaga
Considerations
Detailed Answer:
hello and thank you for sending the question.
This type of situation is a very common reason for referral to hematologists. Your white blood cell count has been mildly decreased from the results you have shared with me. It is important to note that your hemoglobin and your platelet count are normal. This generally indicates that a primary process involving your bone marrow is unlikely. This could simply be an auto immune process that causes a mild decrease in your white blood cell count.
However, if this continues to cause you significant stress and anxiety I would recommend asking for the bone marrow biopsy which would help to completely rule out any issue with your bone marrow that could cause low white blood cell count.
I assume that your doctors have checked other labs including vitamin B 12 and folic acid levels which can sometimes contribute to a low white blood cell count.
Again I do not suspect that you have anything like leukemia or lymphoma but if you would like the extra level of reassurance then a bone marrow biopsy would be worthwhile.
Thanks again for sending your question.
Sincerely,
Dr. Galamaga
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
what does the diff type mean that my Neutrophils are 72.88%,Lymphocyts 13.92%,Monocytes 10.46%, Eosinophils1.46% Basophils 1.28% are any of these differential types of danger especially the Neutrophils and Lymphocytes. I think the only reason I would have a bone marrow biopsey is because of the anxiety and stress. 4 doctors told me not to worry. its easier said than done. I have been told by my GI Dr. not to have one unless it is absolutely necessary
Brief Answer:
Follow up
Detailed Answer:
thanks for the follow-up question.
Those percentages are measurement of the different types of white blood cells that are circulating through your bloodstream. Each type of white blood cell plays a particular role in the function of the immune system. You have normal numbers of these particular cells. It is just your total white blood cell company is low.
Again it's reasonable to wait and I do not see a strong indication for bone marrow biopsy right now. However if you continue to have severe anxiety and worries then it might be a reasonable consideration for you to discuss with your doctor.
Thanks again for sending your question.
Dr. Galamaga
Follow up
Detailed Answer:
thanks for the follow-up question.
Those percentages are measurement of the different types of white blood cells that are circulating through your bloodstream. Each type of white blood cell plays a particular role in the function of the immune system. You have normal numbers of these particular cells. It is just your total white blood cell company is low.
Again it's reasonable to wait and I do not see a strong indication for bone marrow biopsy right now. However if you continue to have severe anxiety and worries then it might be a reasonable consideration for you to discuss with your doctor.
Thanks again for sending your question.
Dr. Galamaga
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
I understand totally what you have told me. I think for the most part for me its anxiety, panic and worry. What does it mean when you say Its just your total white blood cell company is low? I have had Multiple Scerlosis for 16 years and have been on the injection Avonex for that period of time. Could this be the auto immune process that you mentioned earlier before and this could be causing my wbc to spiral up and down? My GI Dr. said a 2.7 was not a severly low number for a wbc.
Brief Answer:
Follow up
Detailed Answer:
hello and thanks for the additional information.
What I meant to say was that it is only your total white blood cell count that is low. Do you have adequate amounts of the various types of white blood cells to maintain adequate immune function. Again your white blood cell count is not dangerously low and very likely does not represent a worry some disease process.
it is possible that your history of multiple sclerosis and long-term use of Avonex May play a role here but again I do not see major concern or immediate need to perform a bone marrow biopsy.
It might be reasonable to continue check your blood count every 4 to 6 months for stability. Lastly as I mentioned earlier if the degree of anxiety that you have is too much to handle and you could proceed and request a bone marrow biopsy to give definitive proof that your bone marrow is otherwise normal.
sincerely,
Dr. Galamaga
Follow up
Detailed Answer:
hello and thanks for the additional information.
What I meant to say was that it is only your total white blood cell count that is low. Do you have adequate amounts of the various types of white blood cells to maintain adequate immune function. Again your white blood cell count is not dangerously low and very likely does not represent a worry some disease process.
it is possible that your history of multiple sclerosis and long-term use of Avonex May play a role here but again I do not see major concern or immediate need to perform a bone marrow biopsy.
It might be reasonable to continue check your blood count every 4 to 6 months for stability. Lastly as I mentioned earlier if the degree of anxiety that you have is too much to handle and you could proceed and request a bone marrow biopsy to give definitive proof that your bone marrow is otherwise normal.
sincerely,
Dr. Galamaga
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Above answer was peer-reviewed by :
Dr. Raju A.T
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