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The Doctors Lounge - Primary Care Answers

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Forum Name: Ear Nose and Throat

Question: Can Chronic Sinusitis cause neutropenia?


stumpedNSJ - Fri Apr 07, 2006 3:38 pm

Hello,

I am a 36 yr old female and I have just been diagnosed with chronic Sinusitis, probably resulting from a severely deviated septum and a nasal polyp. This was discovered by accident when I had a brain MRI for another reason. The only symptoms I have been having that would relate to this is a chronic runny nose and chronic fatigue.

My question is this - Could this chronic infection be the underlying cause of chronic Neutropenia as well? I have had low neutrophils and High lymphocytes for about 9 months now and my hematologist is testing me every 3 months.

It is really bothering me that we can't get to the bottom of this.

Thanks you for you response,
Theresa Jones, RN - Tue Apr 25, 2006 1:14 pm

Hi stumpedNSJ,
Neutropenia may be caused by numerous reasons, ie, drug induced, viral infections, bone marrow dysfunction, malignancies, etc. Has there been any mention of a bone marrow aspiration/biopsy?
Sincerely,
Theresa Jones, RN
stumpedNSJ - Tue Apr 25, 2006 3:02 pm

I appreciate your response.... The hematologist has never mentioned the biopsy. Please see my original posting in the "hematology" forum. It tells the whole story.
Would you seek a second opinion if you were me?

Stumpednsj
Theresa Jones, RN - Wed Apr 26, 2006 11:15 am

Hi stumpedNSJ,
I did read some of the other posts that you have written. A viral etiology (HIV) can be essentially ruled out since the testing was negative. Your work doesn't involve exposure to toxic chemicals does it? Keep in mind that some people do have abnormal lab results without an underlying disorder. However, in my opinion, taking into consideration that this is a long standing problem and the fact that you have physical symptoms and feel generally unwell, a bone marrow aspiration/biopsy would be at least an approachable topic with your physician. This would identify if an underlying dysfunction or malignancy is present. I would strongly suggest that you either discuss this with your current physician or obtain a second opinion. Best wishes.
Sincerely,
Theresa Jones, RN
stumpedNSJ - Wed Apr 26, 2006 2:59 pm

Thank you for taking the time to read my history... I have scheduled an appointment with another hematologist for a second opinion who was recommended to me by my new primary care physician. He also agrees that this is something that needs to be investigated further. Hopefully this will finally put my mind at ease.

stumpednsj
Theresa Jones, RN - Wed Apr 26, 2006 6:42 pm

Hi stumpedNSJ,
You are quite welcome. I hope that when your time permits you will consider posting an update.
Sincerely,
Theresa Jones, RN
rjshprabhakar - Sun May 28, 2006 1:41 pm

Hi stumped,
Well chronic sinusitis and lymphocytosis are not related to each other except for tubercular sinusitis which can lead to systemic lymphocytosis. If it is a allergic condition leading to sinusitis then there can be blood eosinophilia but not lymphocytosis. Complete blood examination is required followed by bonemarrow cytology if required. Since peripheral blood film can tell us about immature cells present in blood which are indicators of malignancy so bonemarrow aspiration depends upon the picture of PBF. Antral lavage can be done from the area of sinusitis followed by culture and senstivity to know the exact cause of sinusitis.
Sincerely
Dr Rajesh Prabhakar

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