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Forum Name: Gastroenterology Topics

Question: abdominal pain- blood work shows high monocytes- low wbc


 Sharoneys - Sun Jun 13, 2010 8:17 pm

My Son has been having stomach pains for a while so we brought him to the Dr and had blood work done. The first time it came back as 14% monocytes and 3.5 WBC count. A few days later we repeated the bloodwork and the monocytes were down to 9% and WBC count was up to 4.4. Does this mean I should still be worried or maybe my son was ill at the time of the bloodwork and is getting better? The Dr. says to keep and eye on it and if the pains continue to see a GI, but the blood counts are still off, so should I do something else??
 Dr.M.Aroon kamath - Mon Jul 05, 2010 11:03 am

User avatar Hi,

Firstly, it may not be prudent to diagnose a monocytosis or monocytopenia based on a differential leukocyte count. At best, an increased monocyte % in a differential count may help to raise suspicion and lead to an "absolute" monocyte count, which is more reliable.

The normal range for monocytes in a differential count is 0-9%.

The normal reference range for an absolute monocyte count is
40 - 950/µL. A value >950/µL is called as Monocytosis.

Monocytosis is seen in some of the following disorders,
- recovery phase of many acute infections,
- chronic infectious disorders (tuberculosis),
- chronic inflammatory bowel disease,
- rheumatic diseases (lupus, rheumatoid arthritis),
- malignant processes (Hodgkin's and non-Hodgkin's lymphoma),
- granulomatous diseases: sarcoidosis, histiocytosis X,syphilis, brucellosis, Crohn's disease etc)
- storage diseases (Niemann–Pick disease,Gaucher's disease),
- Parasites (malaria),&
- drugs (methsuximide, griseofulvin, and haloperidol).

Monocytopenia can occur in the context of
- glucocorticoid therapy,
- acute infections,
- aplastic anemia,
- stress,
- leukemias (acute myeloid leukemia, hairy cell leukemia,&
- drugs (myelotoxic drugs).

It is very likely that your son had a fleeting viral illness that caused the "monocytosis". However, It is better that your son gets a full blood work-up including an absolute monocyte count.That will also help alleviate your continuing anxiety. You may discuss with your doctor who will surely guide you regarding this.
Best wishes!

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