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- Sat Jan 21, 2006 7:09 pm
I am a 22 year female who recently had a CBC done at my dermatologist office. My reselts came back abnormal and now I am very concerned. Everything was normal except for:
WBC 3.3 --3.8=10.8
Ab. Neutrophils 1238--1500-7800 cells/mcl
Monocytes 165L--200-950 cells/mcl
I have also been experiencing some pins and needles in my hands and feet. Any ideas on what may be wrong?
| Dr. Tamer Fouad
- Sun Jan 22, 2006 6:36 am
Leukopenia is defined as a reduction in the circulating WBC count to < 4000/µL.
Neutropenia is defined as a reduction in the blood neutrophil (granulocyte) count. This can lead to increased susceptibility to infection.
In whites neutropenia occurs when the neutrophil count is less than 1500/µL. Blacks have somewhat lower neutrophil counts, the lower limit of normal for them being 1200/µL.
Neutropenia may be classified by the neutrophil count and the relative risk of infection into mild (1000 to 1500/µL), moderate (500 to 1000/µL) and severe neutropenia (< 500/µL). Acute, severe neutropenia caused by impaired neutrophil production is often life-threatening in immunocompromised patients.
On evaluating a case of neutropenia the first thing is to exclude secondary neutropenia resulting from an external cause.
Causes of secondary neutropenia include drugs, vitamin B12 or folate deficiency, malignancy, bone marrow disease and splenomegaly. Transient neutropenia often accompanies some infections (eg, early-stage infectious mononucleosis, HIV and sepsis). Autoimmune neutropenias may be associated with the presence of circulating antineutrophil antibodies and may occur in isolation or with associated autoimmune diseases.
After excluding the above causes there remains a category known as primary neutropenia. This form of neutropenia is rare and includes cyclic neutropenia, congenital neutropenia and chronic idiopathic neutropenia.
Monocytopenia occurs with acute infections, with stress, and after treatment with glucocorticoids. Monocytopenia also occurs in aplastic anemia, hairy cell leukemia, acute myeloid leukemia, and as a direct result of myelotoxic drugs.
Are you currently taking any medications? The presence of mild anemia and mild neutropenia in your case could point to an early vitamin B12 or folate deficiency. Are you pregnant? Why did you need to go to a dermatologist? Do you have any autoimmune diseases? Did you have a recent viral infection?
- Sun Jan 22, 2006 12:31 pm
No I am not pregnant. I went to the dermatologist for acne which I've had since middle school. I'm not taking any oral medication, but am using topical ance medication. The week before the test I received vaccinations for typhoid, hepatitis A and B for I a trip I was about to take. Could this have affected the test. The viral infection I guess I've had would be having cold sores. I've gotten them since I was young, and usually get one every couple of months. Could this also be affecting the test?
Thanks for your help.