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Forum Name: Hematology Topics

Question: Concerned Labs- Elevated WBC,Absolute Neutrophils & Monocyt


 HappynSassy - Wed Aug 11, 2010 9:50 am

I am a 38 yr old female , under physician care for weight management, currently 244 and dropping. My fasting blood work returned with some "Out of Range" results. I requested a copy of the results for my records and discovered the following when the Tech had not an said we would review on my next visit. It has been back for 2 weeks and no one has gone over with me to explain, when I ask - "No one is available". So I just want to know if there is a need for concern that I need to make an appointment w/a specialist immediately or can it wait ? These are the out of range results:

Cholestrol,Total / 230H
LDL-Cholesterol / 140H
Carbon Dioxide / 18L
WBC/ 13.6H
Absolute Neutrophils/ 9071H
Absolute Monocytes /1659H

Everything else is normal . I guess I am more concerned over the WBC and Neutrophils and Monocytes than anything else. I am hoping that with better eating choices the Cholestrol will fall back into place .

Any direction is greatly appreciated. ;-)
 Dr.M.Aroon kamath - Thu Aug 12, 2010 1:49 pm

User avatar Hi,
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,
- rheumatic diseases (lupus, rheumatoid arthritis),
- malignant processes (Hodgkin's and non-Hodgkin's lymphoma),
- chronic infectious disorders (tuberculosis),
- chronic inflammatory bowel disease,
- storage diseases (Niemann–Pick disease,Gaucher's disease),
- granulomatous diseases: sarcoidosis, histiocytosis X,syphilis, brucellosis, Crohn's disease etc)
- Parasites (malaria),&
- drugs (methsuximide, griseofulvin, and haloperidol).

There is a paucity on information on conditions where both the absolute neutrophil count and the absolute monocyte are consistently raised together.

A combination of raised monocyte and neutrophil counts were seen to be associated with cardiovascular disease in a relatively healthy elderly population.
(Experimental Gerontology,
Volume 39, Issue 4, April 2004, Pages 615-619).

Severe hyperlipidemia has been reported to affect the hemogram values(using automated analysers) as follows.
- may raise the hemoglobin levels,
- may falsely elevate leulocyte counts,
- may falsely elevate monocyte counts and
- falsely lower the lymphocyte counts.

These fallacies were recognized following manual differential counts.
(Clinical Chemistry and Laboratory Medicine. Volume 46, Issue 7, Pages 1054–1055).

Both your total cholestrol and the LDL cholestrol are in the "borderline high" ranges (perhaps not high enough to affect the hemogram values).

Therefore, i would suggest that you should first get these tests repeated. If a similar pattern is seen yet again, one may need to look for separate causes for the leukocytosis and the raised monocyte counts.
Best wishes!

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