CBC result questions

[Adollins]

Hi there! I’m new to the forums, and honestly I’m not sure what to even ask...
I recently went in for a routine physical with my PCP and I had lab work done. I let my doctor know that I had some heart palpitations over the past several months, felt overly fatigued, and had a few migraines. I also have recurrent UTIs. Other than that, I’m fairly healthy.
A few days after my appointment I received my CBC results and there were a few things that were alarming to me. High MVP, lower WBC, lower RBC, low platelets, and poikilocytes +1/hpf. I went ahead and shared my information with a few of my medical professional friends, and they said that if they were my doctor, they would definitely refer me to a hematologist. I called my PCP and sure enough, they wanted me to see one.
My appointment isn’t until the 14th of March and I am driving myself crazy trying to figure out what is wrong, or if I should be concerned. I was hoping someone could shed some light on my situation (or non-situation).

Thank you!
Ali

WBC: 4.8
RBC: 4.2
Hemoglobin: 13.5
Hematocrit: 40.3%
MCV: 95.3
MCH: 31.9
MCHC: 33.5
RDW: 12.6%
Platelets: 118
MPV: 14.9
Neutrophils: 56%
Lymphocytes: 34%
Monocytes: 7%
Eosinophils: 2%
Basophils: 0%
Immature Granulocytes: 0.1
Neutrophil absolute: 2.68
Lymphocyte absolute: 1.60
Monocyte absolute: 0.35
Eosinophil absolute: 0.1
Basophil absolute: 0.02
Immature granulocytes absolute: 0.01

[DanL]

Ali,

I'll start off by stating that I am not a doctor. I am a long-term MDS patient, and was diagnosed with blood disorder back in 2010 as the result of a routine physical where I asked my doctor to draw some blood. After that appointment, I found out that I had pretty normal white and red blood cell counts, but I only had about 26k platelets (about 1/6 of normal). I was immediately referred to a hematologist. After several months of guessing that I had ITP (idiopathic thrombocytic purpura), or low platelets for an unknown reason, we finally did a bone marrow biopsy and discovered that I had MDS.

Reviewing your numbers, there really isn't a lot of information there that would indicate healthy marrow or unhealthy marrow. Blood tests are a moment in time, and don't really give a good picture, unless you have a series of them to look at showing a trend. I'll give you an example - with my recent blood counts, I have had white blood cells ranging from 4.5 (normal) to 15,500 (abnormal high). Without knowing that I was fighting a pretty nasty infection, the high number might be disconcerting. As the infection was treated, my white blood cell counts dropped, but then my platelets dropped from normal (175k) down to 96k, which is low. This is because I picked up a viral infection and was taking antibiotics that have a tendency to knock down platelets in some patients.

To a person with bone marrow failure disease, your platelets, RBC, and HGB and HCT appear a little low based on overall population averages, but are pretty darned close to normal. People with bone marrow failure frequently have numbers that are horribly out of line - hemoglobin of 8, hematocrit of 25, platelets below 50k, white blood counts below 2.0.

Seeing a hematologist is probably a wise step to take just to be sure that there isn't something wrong, but the lower numbers could be the result of an infection, vitamin deficiency, or other process, just as much as it could be from something more serious.

I hope that this turns out to be completely benign, but know that you have a lot of good resources available on this forum if you should need them in the future.

Dan

[Adollins]

Dan,

Thank you for your reply and calming my nerves. I am actually about to head back to my PCP to do a redraw this afternoon. The last CBC that I had done was back in 2009, and my WBC, RBC, and platelet counts have dropped since then (but that was 9 years ago and it was during my pregnancy).

I am anxious to see what has changed in the last 3 weeks. For now, I think I just need to be patient and stop worrying.

Ali