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This question was answered on Sun 09, Aug 2009 03:26am by Dr. Monica, MD

Differential WBC counts..does it mean anything?


    
Asked by ajhyd (Male; 38; Health Sound. No Smoking. No Drinking (Except in social get togethers Beer/Wine) Father had heart problem at age 50. Mother no problems. Grand mother(Mother's mother) died of cancer at age around 55-60years. ) on Wed 05, Aug 2009 09:36pm

I Had a routine blood test done during physical exam in 2008 and there was a difference observed in WBC differential counts. (Low Neutrophils -11%, High Lymphocytes-50%, High Monocytes -11%. All other counts are normal like, platelets, RBC, hemoglobin, absolute counts etc. I was asked to take a chest x-ray and tb blood test. Result came as -Negative. Repeated the blood tests after 2 months 2 times but the same numbers. Later took a blood test for H. pylori and it came as "Positive". I was put on antibiotics for 2 weeks and later blood test was performed after 6 weeks. Again the same numbers came around. I was reffered to a Gastro and the Doc performed a endoscopy and colonoscopy. Observed Esophagitis and Gastritis. I was put on antibiotics for 2 weeks and breath test was done after 6 weeks, the result was again "Positive". New anitibiotics were given again for next 2 weeks and breath test was repeated after 4 weeks. Test came "Negative". Now again when routine blood test was done after 6 months, again the same mismatch(high/low) in WBC count? What should I do? I am really tired and worried about these number mismatch. Does this mean there is either some infection in my body yet undiscovered some where or anything related to leukamia. Please guide me. Should I ask my doctor to perform a CT scan or Bone marrow test? Appreciate all your help and advice in this regards.
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Answer by Dr. Monica, MD  on Sun 09, Aug 2009 03:26am:

Hi, Your blood tests show an increase in the precentage of lymphocytes with normal absolute counts. This indicates a relative lymphocytosis. The most common cause is infections. The H. Pylori infection may be a likely cause. After the infection is controlled the counts gradually return to normal. Has there been a decrease in your lymphocyte counts or have they remained the same? Other probable causes include viral infections, infectious mononucleosis, tuberculosis, protozoal and fungal infections. In leukemia and other lymphoroliferative disorders, the absolute number of lymphocytes is increased and the other blood cell counts are generally decreased. Since you are completely asymptomatic at present, you can opt for observation or for further investigations. Please discuss with your doctor regarding the need for further investigations. All the best

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Follow up:

Clarification by ajhyd on Wed 12, Aug 2009 11:01pm: 
Thank you very much Doctor. I just got a recent(1 week back) blood test done and everything is normal except
for the above counts. As I changed my doctor recently, he mentions the report is normal, but I am still
worried why will the numbers be coming the same way (Low Neutrophils -11%, High Lymphocytes-50%, High
Monocytes -11%) repeatedly. I do not have any symptoms then or even now. Should I be worried? Are there any
specific tests, that I should ask my doctor to further conduct? Please guide me.

Appreciate all your help in this regard.

Comments:

Comment by Dr. Monica, MD on Sun 16, Aug 2009 06:31am: Hi, Since you do not have any symptoms, there may not be any reason to be worried about. Did you have a blood examination anytime before 2008 that showed normal differential WBC counts?

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