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Post subject: red blood cell count, please help.
kat - Thu Nov 25, 2004 12:37 pm |
hi there,
please can you help me in understanding my blood cell count that just came back. i will just list the abnormal ones.
haematocrit - 0.345 (lowest level 0.37)
RBC count - 3.71 (lowest 3.9)
WBC count - 2.8 (lowest 4.0)
red blood cell distribution width - 15.2 (normal 10-15)
neutrophil count - 1.2 (normal 2-8 )
what do u think these counts could suggest? what different blood tests or whatever would u think about doing? im a 20 year old female, just under a year ago was in hospital for 3 weeks with a mystery 'virus' and enlarged spleen, i had a bone marrow biopsy done but showed no abnormal cells. have just finished my 7th lot of antibiotcs this year since january and had to go into hospital again for IV antibiotics for cellulitis in my leg. but blood count hasnt shown any significant abnormality before. liver, kidney functions were normal and urine normal.
what can cause both the red cells and white cells to be low? even if we cannot diagnose the specific problem are there any treatments i could have to feel better?
any suggestions or input would be greatly appreciated thanks, kat xxx
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Post subject: Re: Red blood cell count, please help.
Yasser Mokhtar, M.D. - Thu Nov 25, 2004 2:25 pm |
Dear Kat,
What was your platelet count on the complete blood count? Why was a blood count checked? What were the symptoms that you have been having?
In general, interpretation of any laboratory result has to be in the context of a clinical setting.
If all your blood counts are low, red cells, white cells (that you already have) and platelets (which you did not mention), then most probably the bone marrow (organ producing the cells) is inhibited by something. This could range from a simple viral infection upto serious disease such as cancer.
If your red cells are only low, this means that you have anemia, which could be related to lots of causes and according to the red cells' size and shape, the cause could be determined by doing further tests.
If your white cells are only low, this could be the effect of a drug, a virus or cancer.
If your platelets are low, it could be secondary to destruction (many reasons) or no production.
i think the most definitive way to finding out what is going on is to have a bone marrow biopsy but this is an invasive procedure and before doing it all other venues (in my opinion) have to be explored.
Waiting for your update.
Thank you very much for using our website http://doctorslounge.com and i hope that this information helped.
Yasser Mokhtar, M.D.
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Post subject:
kat - Thu Nov 25, 2004 3:26 pm |
thankyou so much for replying so soon! i was hoping someone would as its really great to know that you can offer a bit of advice about this.
to some of the things u asked...
i don't know my platelet count, the nurse just reported to me the levels which were above or below the 'normal range' so i dont know if platelets were high or low within that range.
a blood count was being checked as the doctor said i probably had a urinary infection as i said i was drinking a lot and weeing quite a bit and felt unwell....the urine came back negative though and so did the glucose blood test.
i suppose to give you an idea of the context a bit more i shall explain...18 months ago i caught glandular fever again as i already had the EB virus when i was 7 (my doc was v surprised i could have it again and looked back at tests and said i had made no IGG to the virus or something). i became very unwell and had very enlarged spleen/liver and tonsilitis blocking my airway/throat...was hospitalised and had IV antibiotics/steroids. i continued seeing my doctor every 2 weeks who was surprised that my EB count remained very high for 10 months, he gave me valaciclovir (antiviral) and ferrous sulphate for mild anaemia. EB count came down and then i developed another 'mystery virus' last december and coughing all the time, weight loss, enlarged spleen, night sweats...no proper diagnosis but i had a bone marrow biopsy which came back ok. i have taken imunovir (antiviral) since and my EB count has remained low so it isn because of this virus.
so i've been not feeling right at all since this happened a year ago and back in hospital for the cellultis and had other infections. i just feel very tired and a bit nauseaus, weak and achey, finding it very difficult to maintain weight and losing bit of weight, i weigh 45 kg and is hard keeping it up despite eating a lot.
you mentioned a few things which could cause white cells, red cells or platelets to be low individually, what could contribute to make both red and white cells to be low? i dont know about my platelets but im guessing they are within the normal range.
my doctor has requested me to have a repeat blood test in 1 months time, do u think this is soon enough?
also, if i pick up an infection with my white cells and neutrophils being this low, could i get quite a bit sicker faster?
thanks so much for your time, kat xxx
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Post subject: Re: Red blood cell count, please help.
Yasser Mokhtar, M.D. - Thu Nov 25, 2004 6:53 pm |
Dear Kat,
Thank you very much for the update.
i would assume that your platelets count is normal.
Since this appears not to be your first blood count, it would be better to ask about the trend of the red cells and the white cells counts, are the counts improving or getting worse? Are you still taking any medications?
Valacyclovir can rarely cause low white count, low red cell count and low platelets as well. i am not really familiar with imunovir to tell you about its side effects.
If your doctor that you are referring to is an infectious disease specialist, that's fine, if not, i would recommend that you be seen by an infectious disease specialist.
Neutophils normally consititute about 75% of the total white cell count. If the count that you refered to as neutrophil count is what is known as the absolute neutrophilic count then by definition (cut off is 1500/cc) it is low but worries start if the absolute neutrophilic count is below 1000/cc and the risk of infection rises greatly if the count drops below 500/cc and if you get an infection, you will most probably be a lot sicker than a person who gets the same infection, but with a normal white count.
The things that can cause white cells and red cells to be low together is either bone marrow depression or a combination of any cause of each like anemia for any reason and then getting a drug or a virus that can cause your white count to go low. The problem could just be that you are anemic, something that is not unheard of in females of your age, because of menstruation (and you have been sick as well) and you taking a medication that is causing your white count to be low and if the medication is stopped or the dose is lowered, this might improve things.
There are medications that can be given to make the white count go up if need be.
Remember, i am just standing outside and looking in, your doctor is the one who has been following you all along. You can take these thoughts to him as friendly suggestions.
Thank you very much for using our website http://doctorslounge.com and i hope that this information helped.
Yasser Mokhtar, M.D.
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Post subject:
kat - Thu Nov 25, 2004 7:42 pm |
thanks very much for replying again.
my doctor is my local gp, not an infectious diseases specialist they decided that i didnt need to see them anymore as i didnt have a persistant infection. ive been taking imunovir since march and blood counts were normal after taking it for months and when i had infection in the summer my counts were normal, up until about 3 weeks ago when my white cells started to show a dip. ah but thinking about it....i've had 3 lots of chloramphenicol this year, that can cause dips in cell counts can't it?
if it were an antibiotic or drug, is there any way to know if it was the effect of a drug? also if it were a drug im not taking at the moment and was taken as a week course?
i hardly lose much blood at all when i menstruate so i don't know if it could be that.
i guess i will just have to wait and see what happens with the results next time. i wish i had just seen one doctor all along then it might make things seem clearer but ive just been passed from different doctor for different things.
thanks a lot again for your time, kat xxxx
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Post subject: Re: Red blood cell count, please help
Yasser Mokhtar, M.D. - Thu Nov 25, 2004 8:25 pm |
Dear Kat,
Thank you very much for the update.
Cholramphenicol can definitely cause this side effect.
i am not sure though how long its effect can last or when can it start.
Please, remember that the viral infection that you might be having may the cause of this and also the imunovir should not be excluded.
i would recommend that you see an infectious diseases specialist.
Thank you very much for using our website http://doctorslounge.com and i hope that this information helped.
Yasser Mokhtar, M.D.
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Post subject:
kat - Fri Nov 26, 2004 10:52 am |
are there any blood tests that can be done to see if it could be a drug side effect? like a test to see if there is a drug toxicity in my blood? like a general one or is that not possible? how can you exclude the possibilty of it being caused by medicine?
thanks again...sorry so many questions!!
kat xx
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Post subject: Re: Red blood cell count, please help
Yasser Mokhtar, M.D. - Fri Nov 26, 2004 1:29 pm |
Dear Kat,
i don't think that there is a specific blood test, unless a specific antibody against the drug in the blood that can be detected but this occurs in certain cases of being allergic to the drug.
Thank you very much for using our website http://doctorslounge.com and i hope that this information helped.
Yasser Mokhtar, M.D.
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