please tell me that whether he has any history of fever,weight loss,or infection of any area?
what is the percentage of neutrophils and lymphocytes in blood complete picture?
yes please when you get information regarding his neutrophils and lymphocytes then you can reply so that i may proceed further accordingly.
I just got the info you requested this morning. These are the average of 6 blood draws from 4/09 to 8/09. His last test was 1/1/10 and his "count" was 16.6 (I'm assuming that is Neutrophils gran)
Neutrophil % 67, Lymphocytes % 24, Monocytes % 8. Neutrophils (gran) 10, Lymphocytes:3.4, Monocytes 1.0.
JAK2 Mutation, Leumeta: negative
JAK2 V617F Mutation detection (NOTE) there was nothing else after that.
All that follows is from the bone biopsy results on 7/22/09
Clinical history of Leukocytosis
Microscopic Description: Specimens reviewed-peripheral blood, FE, TP and decalcified trephine biopsy. The peripheral blood smear shows borderline leukocytosis composed predomiantly of neutrophils. A rare circulating myelocyte is seen but there is no significant left shift or basophilia. Red cells and platelets are normal. Bone marrow shows a cellularity of 20-30%. Magakaryocytes are present and adequate. Erythroid and granulocytic precursors show complete maturation. No metastatic tumor. No lymphoma/lymphiod aggregates. No granulomas. Bony trabeculae are unremarkable.
COMMENT: Due to the lack of aspirate and quality of touch prep, maturation cannot be fully assessed. However, the biopsy shows complete maturation of both erythroid and myeloid elements with no abnormal localization or clusters or blasts.
I hope this helps. Thank you.
thanks for a nice info as his problem is just neutrophilic leucocytosis rest of his parameters are with in normal range,his workup fo jak 2 mutations are negative,good maturation of other cells in bone marrow biopsy with no evidence of any blood cancer and no evidence of infection is highly encouraging and good news :) now we have to sort out the cause of neutrophilic leucocytosis The most common and important cause of neutrophilia is infection, and most infections cause neutrophilia but in this case no evidence of infection seen so this is highly unlikely.Tissue damage from other causes raises the white count for similar reasons. Burns, infarction (cutting off the blood supply to a region of the body so that it dies), crush injuries, inflammatory diseases, poisonings, and severe diseases, all cause neutrophilia.Drugs can also cause leukocytosis. Cortisone-like drugs (prednisone), lithium, and NSAIDs are the most common offenders
here i want to share important,last but not leaset cause of neutrophilic leucocytosis if no other cause found then it has been seen thtan non-specific stresses also cause white blood cells to increase in the blood.and they concluded this fact by extensive testing of medical students reveals that neutrophilia accompanies every examination. Vigorous exercise and intense excitement also cause elevated white blood cell counts.so if even no other medical cause can be found than we should think of these some conditions.
Yes as i mentioned stress can result in to elevated white blood cell count as and acccrding to your statement he has quite stressful life,second in the background of high blood pressure high cholestrol level and stressful life he may need evaluation for heart disease as infarction(cutting of blood supply)can result in to neutrophilic leucocytosis.
thankyou sir you are most wellcome :)