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Forum Name: Other infections

Question: Low neutrophils & high lymphocytes


 mdipna - Sun Jul 11, 2010 12:29 pm

i do not have other than gas problem in near past. however i got my boold checkup and results were :

wbc : 6700
neutrophils : 32
lymphocytes : 62
eosinophils : 5
basophils : 0
monocytes : 1
esr : 5
rbc : 4.84
haemoglobin : 15.10
abnormalities of rbc : normocytic normochromic

currently i do not have any symptoms of any disease except that of gas.

is this result show serious problem? do i have to take care in any specific manner hence forth?
 Dr.M.Aroon kamath - Mon Jul 12, 2010 7:31 am

User avatar Hi,
While performing a differential leukocyte count, 100 cells in a stained peripheral blood smear are counted and reported as percentages. If the lymphocyte % is increased, others have to decrease proportionately out of a total of 100.This is known as 'relative' lymphocytosis.

What is more accurate is "absolute" count of each of the different leukocytes.

In subjects >12 years of age, lymphocytosis is defined as an absolute lymphocyte count (ALC) >4,000/µL (also expressed as >4,000/mm3 or >4.0 x 10(9)/L). ALC's are higher in neonates and young children(counts as high as 8,000/µL).This is known as "absolute" lymphocytosis.

Lymphocytosis is a fairly common occurrence and is seen at some point of time in most people's lives, usually in association with viral infections. Lymphocytosis is commonly short lived, and extensive investigations of such cases by is both unnecessary and unrewarding.

There are many other uncommon causes of absolute Lymphocytosis which include,
- viral infections (infectious mononucleosis, cytomegalovirus infections, hepatitis) etc,
- protozoal infections(toxaplasmosis,trypanasomiasis),
- acute bacterial infections(pertussis),
- chronic intracellular bacterial infections(brucellosis, tuberculosis),
- acute lymphoblastic leukemia, and
- chronic lymphocytic leukemia.

What your differential count showed is relative lymphocytosis.
Apart from the minor viral illnesses already alluded to, there are some other conditions which can cause relative lymphocytosis such as,
- Addison's disease,
- thyrotoxicosis,
- splenomegaly with sequestration of granulocytes, and
- connective tissue disorders.

I hope this information is useful to you.
Best wishes!
 mdipna - Mon Jul 12, 2010 11:16 pm

thanks DR. M. AROON KAMATH. this releave my tension.
I am 33 year old. can u through light on my RBC abnormalities in the report, are that serious?
I have acute gas problem. i keep on warping or faltering throughout the day.
does all / any of the abnormality reported has any connection to my gas problem?
if not what should be done for gas problem. here i shall reveal that i have good amount of time between 2 food intake, except that i drink tea. but based on the type of work it will be difficult to change my duration of intakes.
 Dr.M.Aroon kamath - Mon Jul 19, 2010 1:21 am

User avatar Hi,
Thank you for keeping in touch. I am terribly sorry, i concentrated more in the differential count!

Normocytic/normochromic (NC/NC) anemia is one in which the average size and hemoglobin content of the red blood cells(RBCs) are within normal range. Usually microscopic examination of the red cells shows that they are much like normal cells in size and depth of staining in a peripheral smear. Usual causes include sudden blood loss, sepsis, tumor, prosthetic heart valves, chronic disease, certain drug therapies or aplastic anemia. Chronic disease and drugs are perhaps the commoner among the causes.

It was a common practice to report normochromia based on the depth of staining of the RBCs in the peripheral smears. The red cell indices now-a-days, also help to determine this.

Sometimes, there may be marked variations in size and shape of the RBCs, but these happen to be such that they tend to equalize one another, thereby resulting in a apparently normal average(normocytic/normochromic).

This possibility may be suspected by scrutinizing the RDW(red cell diameter width) value, which is normally included as component of complete blood count. RDW is a measure of the variation of volume of the RBCs.

One notable example are the Sideroblastic anemias. They are anemias characterized by inadequate marrow utilization of iron for Hemoglobin synthesis despite the availability of adequate or increased amounts of iron (iron-utilization anemias). Although hypochromic RBCs are produced, increased RDW results in the picture of a normocytic/normochromic anemia (as per the RBC indices), if one overlooked the RDW value!

I hope this information is helpful.
Best wishes!

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