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Forum Name: Other infections

Question: Red Blood Cells Lyme Disease


 Joan22 - Wed Mar 10, 2010 12:48 pm

About 4 weeks ago I was diagnoised with active lyme disease. I had been very sick for 3 months with the symtoms. I thought it was stress, but finally got tested for it. I tested positive on the elisa and WB for active infections (I specifically met like band 41 and 23 of the IGM (whatever is the one that indicates active lyme disease) the one that I guess all doctors agree on bc 3 doctors looked at my test in the office and said there was no doubt I had active lyme. I had all the joint pains, muclse aches, ect. I've been hiking recently. I went to a lyme specialist 4 weeks ago who also thinks I may have co-infections. He put me on 400mg of Doxycline (I am getting better, but a few symtoms are not responding, but most are) and I go back on Monday for a review of the co-infection blood test, he suspects 2 other infections (babesia, bartonelli I think). However I had over looked having general blood work done for my yearly physical until yesterday. I just go the bloodwork back and I noticed 3 red blood cells values were out of wack. Red and White blood cells were fine. Last year my values were all normal. I have been craving iron for a while and that's not me. I guess my question is can Lyme disease do this? I guess I want the peace of mind that this is not cancer sneaking up on me.

Abnormal Values:
Hematocrit 46.5 (high)
MCV 101 (High)
MCHC 31.6 (Low)

Complete Test:
WBC 6.5 x10E3/uL 4.0-10.5 01
RBC 4.60 x10E6/uL 3.80-5.10 01
Hemoglobin 14.7 g/dL 11.5-15.0 01
Hematocrit 46.5 HIGH % 34.0-44.0 01
MCV 101 HIGH fL 80-98 01
MCH 32.0 pg 27.0-34.0 01
MCHC 31.6 LOW g/dL 32.0-36.0 01
RDW 13.0 % 11.7-15.0 01
Platelets 229 x10E3/uL 140-415 01
Neutrophils 47 % 40-74 01
Lymphs 39 % 14-46 01
Monocytes 13 % 4-13 01
Eos 1 % 0-7 01
Basos 0 % 0-3 01
Immature Cells 01
Neutrophils (Absolute) 3.1 x10E3/uL 1.8-7.8 01
Lymphs (Absolute) 2.5 x10E3/uL 0.7-4.5 01
Monocytes(Absolute) 0.8 x10E3/uL 0.1-1.0 01
Eos (Absolute) 0.1 x10E3/uL 0.0-0.4 01
Baso (Absolute) 0.0 x10E3/uL 0.0-0.2 01
Immature Granulocytes 01
Immature Grans (Abs) 01
NRBC 01
Hematology Comments: 01
Glucose, Serum 89 mg/dL 65-99 01
BUN 9 mg/dL 5-26 01
Creatinine, Serum 0.71 mg/dL 0.57-1.00 01
eGFR >59 mL/min/1.73 >59 01
eGFR AfricanAmerican >59 mL/min/1.73 >59 01

Note: Persistent reduction for 3 months or more in an eGFR
<60 mL/min/1.73 m2 defines CKD. Patients with eGFR values
>/=60 mL/min/1.73 m2 may also have CKD if evidence of persistent
proteinuria is present. Additional information may be found at
www.kdoqi.org.
BUN/Creatinine Ratio 13 8-27 01
Sodium, Serum 140 mmol/L 135-145 01
Potassium, Serum 4.2 mmol/L 3.5-5.2 01
Chloride, Serum 104 mmol/L 97-108 01
 Dr.M.Aroon kamath - Tue Jun 22, 2010 12:42 pm

User avatar Hi,
Going through your labs, the CBC results appear to be a bit confusing.

Macrocytic/normochromic anemias (associated with vitamin B12 and folate deficiency) usually show
- a high MCV(mean corpuscular volume),
- a normal MCHC(mean corpuscular hemoglobin concentration) &
- a raised MCH.

In your case, the MCV is just above the upper limit of normal laboratory reference range, the MCH is normal & the MCHC is just below the lower limit of the normal. Usually the terms macro and microcytic are based on the MCV. Terms hyper, hypo and hypochromic are based on the appearance of the Red blood cells on a peripheral smear.This kind of a confusing picture may occur when a combined deficiency exists (vitamin B12/folate + iron deficiency).

Associated iron deficiency may cause the MCV being normal, in which case two types of red blood cells (macro & microcytic) may be seen (a dimorphic blood film). The ferritin level should be checked if such a picture is seen.

One other aspect needs explanation.When your CBC is showing these abnormal values, why your hemoglobin is normal?. It is well known that in megaloblastic anemias, the MCV sometimes increases much before the anemia appears.

Therefore, in your case, it may be better to have an opinion of a hematologist.Also it may be useful to fully investigate for vitamin B12/folate & iron deficiencies.

Your craving for the iron perhaps indicates an iron deficiency, as craving for many non-food items(Pica) is well known in this condition.

I am not sure if all these problems are related to the Lyme disease. A good hematologist may be in a better position to unravel this picture.
Best wishes!

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