Advice please if possible

[pettyt65]

Does anybody understand this pleasePathology Investigations

Full blood count Rouleaux +

Lymphocytosis persists

Film reviewed by Laura Gorman (Biomedical Scientist)

FILM REFERRED TO CONSULTANT HAEMATOLOGIST

note raised esr and leukocytosis? underlying cause

Dr John Ashcroft

Haemoglobin concentration 142 g/L [115.0 - 165.0]

Total white blood count 14.8 10*9/L [4.0 - 11.0]; Outside reference range

Platelet count - observation 473 10*9/L [135.0 - 400.0]; Outside reference range

Red blood cell count 5.10 10*12/L [3.8 - 5.5]

Mean cell volume 88.8 fL [80.0 - 98.0]

Haematocrit 0.453 1/1 [0.37 - 0.47]

Mean cell haemoglobin level 27.8 pg [27.0 - 35.0]

Mean cell haemoglobin concentration 313 g/L [300.0 - 350.0]

Red blood cell distribution width 13.6 % [0.0 - 14.0]

Neutrophil count 6.05 10*9/L [2.0 - 7.5]

Lymphocyte count 6.60 10*9/L [1.0 - 4.0]; Outside reference range

Monocyte count - observation 1.28 10*9/L [0.2 - 0.8]; Outside reference range

Eosinophil count - observation 0.66 10*9/L [0.04 - 0.4]; Outside reference range

Basophil count 0.16 10*9/L [0.0 - 0.1]; Outside reference range

Nucleated red blood cell count 0.0 10*9/L [< 0.0] Above Recommended Range

Erythrocyte sedimentation rate 25 mm/h [1.0 - 14.0]; Outside reference range

[Happyrosie]

are you asking how to interpret these results? You seem to be asking for a diagnosis.

[springcross]

Hi petty65. Have you asked your GP?

[b1b1b1]

I once had blood tests with some outside reference range. My doctor said he would retest in several weeks, and if still abnormal would refer me to a hematologist. At a minimum you might want to ask your doctor what he plans to do about these abnormal blood tests.

[bamboo89]

I'm not a scientist or a pathologist but Lymphocytosis is usually caused by an infection, either viral or bacterial - have you had an ongoing infection of some sort? Most of the out of range tests are related to infection/lymphocytosis of some sort. Are you seeing or speaking to a doctor about these results at some point? If not, you need to...

[pettyt65 in reply to bamboo89]

No had no infections or anything at all, just keep getting bloods done with no answers to anything ,I just feel completely drained out,having day n night sweats,weight loss I also have a swelling below my right collar bone which the doctor says its muscle,this has grown in size and can give me no end of pain at times,I never new muscle can just swell for no apparent reason, I feel like I'm screaming out for answers but getting told absolutely nothing but may be infection or inflamation,i think they dont believe me that's how it's all making me feel

[bamboo89 in reply to pettyt65]

Oh, its a nightmare when there's something wrong and they don't come up with a diagnosis, I know what that's like... Now, in regard to how to read the bloods, the figures in brackets are what the 'normal' range is for a particular component - if the number you have is higher or lower than the figures in brackets, then its 'abnormal' and it will say outside the normal range or something similar. Your haemoglobin concentration, for instance, is 142, the figures in the brackets are 115.0 - 165, so your haemoglobin concentration is within normal range. For your purposes, you can largely ignore the 'within normal range' components. When you exclude those, you're left with mostly those referring to your immune system, and these are all raised - such as raised white cell count, neutrophils, lymphocytes, monocytes, eosinophils and basophils. Also raised platelets for some reason, obviously connected to whatever's going on - more platelets than there should be just means your blood is more 'sticky' and clots faster and I'd be asking him about that. And you clearly have something going on because you've listed symptoms you're experiencing which are likely connected with some sort of infection. Seems they have they done your bloods previously but did they get abnormal results? Its quite common for various components in the blood to be raised, this is why they repeat them to see if whatever it is has gone or got worse. There is a reference to both leukocytosis and lymphocytosis in your list, at the start, so I'm wondering if they already knew you there's something going on, but didn't know why. Common causes can be things like Epstein Barr or infectious mononucleosis, but I'd definitely be pressing the doctor and making a nuisance of myself to try to get a diagnosis, and asking about all the immune factors being high, and not just by a point or two either, as well as the platelets. If the cause is viral, more difficult for them to make a diagnosis, but in that case, I'd still be asking them what infections can be excluded. That 'muscle' thing under your collarbone is very odd.... if it was on top of your collarbone I'd be asking them to check that it isn't a swollen lymph node. Actually I'd ask him that anyway...

Google everything you're told or have on a piece of paper to expand your own understanding of possibilities., then you can ask about those. You've got a fight on your hands so knowing more yourself from your own research is necessary - it can be exhausting, so good luck with it.

Note: I forgot, the esr, which is raised, refers to inflammation, but it's non specific so doesn't tell us much except it's generally raised.

[pettyt65 in reply to bamboo89]

I also got these too, I'm just not clued up with stuff like this it to complicated for meBone profile

Serum calcium level 2.39 mmol/L

Serum adjusted calcium concentration 2.46 mmol/L [2.2 - 2.6]

Blood haematinic levels

Serum vitamin B12 level 293 pg/ml [191.0 - 663.0]

Serum ferritin level 140 ug/l [12.0 - 233.0]

Serum folate level 4.6 ng/ml [2.4 - 26.8]

Liver function tests

Serum alanine aminotransferase level 17 u/L [< 40.0]

Serum albumin level 43 g/L [35.0 - 50.0]

Serum alkaline phosphatase level 127 u/L [30.0 - 130.0]

Serum bilirubin level 4 umol/L [< 21.0]

Serum TSH level 1.60 mU/L [0.27 - 4.2]

Urea and electrolytes

Serum sodium level 142 mmol/L [133.0 - 146.0]

Serum potassium level 4.4 mmol/L [3.5 - 5.3]

Serum urea level 12.7 mmol/L [2.5 - 7.8]; Outside reference range

Serum creatinine level 78 umol/L [45.0 - 84.0]

eGFR using creatinine (CKD-EPI) per 1.73 square metres 72 mL/min/1.73m*2; Calculated eGFR is not valid in children or pregnancy.

Less accurate with acute change in creatinine (AKI).

Caution with high or low muscle mass or amputation.

Avoid blood sampling within 12 hours of eating meat.

Acute kidney injury warning stage 0; AKI Stage 0 - Report without Alert (6)

Plasma glucose level 5.6 mmol/L [2.5 - 7.8]

Xxxx

[bamboo89]

Well the doc's certainly checked everything he can - I don't know what the calcium thing means except it seems normal levels, the liver tests are all normal, U & Es (kidney function), you've got raised urea, no idea why, and the thyroid test appears normal. Vitamin B12, folate and ferritin also normal levels. Low folate can affect immune function, but yours is within normal range. Whilst I can tell you what they're checking with these tests, I do not have the knowledge to interpret what they mean medically for you, that's the doc's job.

[pettyt65 in reply to bamboo89]

Thank you love for taking your time out to reply ,your help as been very much appreciated xxx

[bamboo89 in reply to pettyt65]

I just remembered the bone profile thing with the calcium readouts is to do with how strong your bones are, whether there's lots of calcium leaching out of them or something, or I think that's what its about... Good luck at the docs, there's definitely something going on with those immune cell results.

[pettyt65 in reply to bamboo89]

Thanks luv,I'll let u know how it goes,I cant thank u enough for taking ur time out to explain things.Xxx

[pettyt65 in reply to pettyt65]

Hi luv these my latest results can u give me any input please

Full blood count Lymphocytosis persists

Smear Cells +

FILM REFERRED TO CONSULTANT HAEMATOLOGIST

Film reviewed by Nicola Short (BMS)

raised granulocyte series as well mild lymphocytosis. suggest

monitoring for now.

10*9/L [1.0 - 4.0]; Outside reference range

Monocyte count - observation 1.05 10*9/L [0.2 - 0.8]; Outside reference range

Eosinophil count - observation 0.58 10*9/L [0.04 - 0.4]; Outside reference range

Basophil count 0.16 10*9/L [0.0 - 0.1]; Outside reference range

Nucleated red blood cell count 0.0 10*9/L [< 0.0] Above Recommended Range

[pettyt65 in reply to pettyt65]

Haemoglobin concentration 144 g/L [115.0 - 165.0]Total white blood count 13.5 10*9/L [4.0 - 11.0]; Outside reference range

Platelet count - observation 447 10*9/L [135.0 - 400.0]; Outside reference range

Red blood cell count 4.94 10*12/L [3.8 - 5.5]

Mean cell volume 87.7 fL [80.0 - 98.0]

Haematocrit 0.433 1/1 [0.37 - 0.47]

Mean cell haemoglobin level 29.1 pg [27.0 - 35.0]

Mean cell haemoglobin concentration 333 g/L [300.0 - 350.0]

Red blood cell distribution width 14.0 % [0.0 - 14.0]

Neutrophil count 4.65 10*9/L [2.0 - 7.5]

Lymphocyte count 7.01 10*9/L [1.0 - 4.0]; Outside reference range

Monocyte count - observation 1.05 10*9/L [0.2 - 0.8]; Outside reference range

Eosinophil count - observation 0.58 10*9/L [0.04 - 0.4]; Outside reference range

Basophil count 0.16 10*9/L [0.0 - 0.1]; Outside reference range

Nucleated red blood cell count 0.0 10*9/L [< 0.0] Above Recommended Range