Quote:
Originally Posted by Neil Cuadra
Bruce,
I'm glad you've told us about your situation, and I hope it won't take much longer for you to get a clear diagnosis.
What are your blood counts like? Just how low? Being tired, bleeding easily, and bruising are the classic symptoms of pancytopenia, which could be from a bone marrow problem. But anemia and easy bleeding are also known side effects of splenomegaly.
"What is causing what?" seems like the medical question that I'd be hoping to have answered. If you have to have another bone marrow biopsy to find out, I don't envy you but I hope it provides the answers, and just as importantly an idea of what treatment is appropriate.
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Hi Neil,
My counts vary. Mostly the RBC and WBC are just mildly cytopenic, every once in awhile they will get into the 2.xx range but mostly hang out in the higher 3.xx. Platelets are consistently hovering around 100k with a low so far of 88k. I haven't had a cbc for a few months though. It is my opinion that something has changed since then, I'll find out at the next appointment.
One concern is that monocytes are always over 20% of the differential. The actual count is always .9 or 1. Never enough to trigger a bigger concern but right at the edge of "normal".
Splenic sequestration is a suspicion but of course why? Just because or because it's destroying abnormal blood cells? The reticulocytosis and marrow hyperplasia indicates the marrow is doing it's best to keep up, no haptoglobin and slightly elevated unconjugated bilirubin means red cells are being destroyed but so far all of the various hemolytic anemia testing and flow cytometry has come back inconclusive.
I'm pretty sure I'm going to request the bmb, maybe even before the next appointment. My recent increase in spleen pain and discomfort have to be happening for a reason.
Thanks,
Bruce