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Forum Name: Hematology Topics

Question: post splenectomy abnormal CBC


 orygun - Thu Dec 27, 2007 6:02 pm

My spleen was removed 21 years ago because I ruptured it in an auto accident. Since then I have been basically healthy, except for occasional high WBCs. In 2006 leukocytosis was added to my health record. I am 50 years old. Last summer I spilled concentrated bleach on my hands causing caustic burns and hypersensitivity to all chemicals such as alcohol, soap, cosmetics, etc. In Nov I had a vitrectomy done. My pre-op blood work concerned my primary care MD. The following were in the high range:
WBC 14.4
Platelet count 384
lymphocytes 6.48
monocytes 1.87
eosinophils .86
In the Diff Cell comments section it said "few reactive lymphocytes"
in the PLT comments "few large platelets, few giant platelets"

A month later I repeated the CBC & the out of normal range were:
WBC 16.9
platelet count 474
neutrophils 9.06
lymphocytes 6.10
monocytes 1.35
the Diff Cell comments stated: "Few reactive lymphocytes, occasional myelocytes seen on scan."
The CBC comments, blood stated: "Microfibrin present; Peripheral blood smear reviewed; automated differential verified".

My MD has sent a sample of my blood to a lab in Canada for what she terms a "special test".

In the past I've had similar WBC counts. Twice I've been referred by a previous primary care MD for an ultrasound of my non-existent spleen. I told my present MD that since I'm a post-splenectomy patient I rarely pay any attention to my bloodwork because my WBC is always elevated. She mentioned a bone marrow test and I realized she was taking this more seriously than I.

Should my WBC still be high 21 years after the splenectomy? I have no symptoms of infection except a slight head cold and frequent night sweats that have been attributed to peri-menopause for the past two years. I did a course of steroids for the caustic burns in September and was using eye drops containing prednisone after the vitrectomy which I was still applying twice a day in one eye when the second draw was done. Could the abnormalities be related to the use of prednisone?

I am not diabetic, I haven't smoked in 19 years and the vitrectomy was a complete success with no complications. Should I be concerned or could the high WBC & platelets be attributed to either the bleach exposure, the prednisone or a combination of the two?
 orygun - Sat Jan 05, 2008 10:48 pm

The results of the special test showed no leukemia...no surprise (this is at least the 4th time I've been tested for leukemia in the past 21 years). My primary care MD is attriubting the elevated WBC & platelets to inflammation, but has no explanation as to cause of the inflammation and hasn't ordered any follow up blood work.

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