High neutrophils/low Lymphocytes/high Absolute Neutrophils

[ApopkaMom]

My labs have been abnormal since Jan 2008, however, the doctors never seem concerned about it even though I haven't felt well. They all keep saying depression/anxiety however, I didn't think could affect bloodwork?

Jan 2008:
neutrophils-70.9
Lymphocytes-16.7
WBC-6.3

July 2008:
neutrophils-81.8
Lymphocytes-11.3
WBC-7.0

Aug 2008
Neutrophils-77.4
Lymphocytes-14.2
WBC-7.0

Sept 2008
neutrophils-72.5
Lymphocytes-15.6
WBC-10.5
Absolute Neutrophil-7.6
Absolute monocyte -1.1
(this lab was performed in the late afternoon and I have read that WBC can be higher in the late afternoon?)

Are these numbers alarming or indicative of an infection of some kind that no one has figured out? Are there any other tests that should be done? Any insight is appreciated. Thank you.

[Dr. Safaa Mahmoud]

Hello,

Although your blood count shows a high absolute neutrophil count and a relatively low lymphocytic count, it is still within the normal range. In addition, the count has been fluctuating within the normal range with no alarming symptoms or signs. All these factors are reassuring and as your physician advised to follow up with a CBC and a complete physical examination is an appropriate decision.

Causes of these changes in the blood count are many and include physical and mental stress (stress leukocytosis), infections (commonly viral), allergies, medications, etc.

Normal values for while blood cell and its elements are:
White blood cells: 4,500-10,000 /mcl.
Neutrophils: 40% to 60%
Lymphocytes: 20% to 40%
Monocytes: 2% to 8%
Eosinophils: 1% to 4%
Basophils: 0.5% to 1%
Band: 0% to 3%

An absolute neutrophil count ANC is a real number of neutrophil count in relation to the total white blood cells (WBCs). The normal range for the ANC is 1.5 to 8.0 (1,500 to 8,000/mm3). Lymphocyte Count (Absolute) range is 1000 - 3500/mm3.

It is also important to examine the blood smear (microscopic) and to see the percentage of segmented and band neutophil. This will be informative especially if infection is suspected (more bands).

I would advise you to follow up with your doctor and to include thyroid function tests in the next follow up.

Please keep us updated.
Best regards.