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May I ask what is the rest of your CBC values? RDW? platelets? Total WBC and neutrophils? MCV?Thanks!Louise Sivak, M.D.
Thank you for the helpful information.
Nothing in your CBC worries me for leukemia.
Your borderline low Hgb is unlikely to be due to iron deficiency (as you astutely point out) as your MCV and RDW are on the high end. Other possible causes for your anemia from this CBC alone would be B12 and/or folate deficiency. You may have had a virus like EBV or CMV (same family) but this CBC wouldn't show recent infection; that requires checking antibodies IgG (high if you've ever been exposed) and IgM (high if you've had it recently). If your creatinine and BUN are normal, it's unlikely you have kidney disease.
Any recent change in the angiomas?
If you are having symptoms related to the mild anemia like shortness of breath, inablility to do everything you want / need to w/o getting tired, then suggest your doctor check B12 and folate levels so you have a baseline rather than just starting supplements "in case".
Hope this helps and please tell me if you have more questions.
Best of luck,
Louise Sivak, M.D.
No the reactive lymphs are indicative of something recent or ongoing (past 3-6 weeks).
Doubt RA but unfortunately it can look like anything.
Recommend you start with the folate, and if you're concerned have your doctor recheck your CBC in 4-6 weeks when reactive lymphs should be gone. If your folate is low and the cause of your slightly higher MCV, MCV should normalize after ~2 months of folate supplements.
No the reactive lymphs don't reflect hormone levels or stress in general but a normal response of the lymphocytes. If you do get another CBC checked then your doctor should do another manual differential so someone can again look at the blood smear (blood on a glass slide) under the microscope. Your reactive lymphs were 3 /100 which is pretty negligible. In a Mono (EBV) infection I typically see 15-25%.
Best of luck.
Whatever was done this time (auto) is fine ; sorry for my confusion. In our lab when the report notes 100 cells counted it's a manual (real person looking) diff. Then if there's any concern a hematopathologist can look him / herself. People are still better than machines for size / shape / cell "character" - anything that's beyond the basics. 3% atypical lymphs on a machine diff is even less concerning to me than on a manual but still deserves follow-up.
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