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Nurse Susan
Nurse Susan, Nurse (RN)
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I was just googling lymphocytes to see if i could figure out

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I was just googling lymphocytes to see if i could figure out how low is low for them. On the CBC test results it says that the normal range is 17.0 - 47.0. Mine is 11.8. Is that considered much out of the normal range?
Hello JACustomer,

Id like to try and help you but I have some questions for you. What prompted you to have blood work done? Are you feeling unwell at all? If so, what are your symptoms? How long has this lasted? Was any other blood value abnormal?

Thanks for clarifying,
Customer: replied 4 years ago.

Neutrophils were 78.5 with normal range 41.0 - 74.0

Glucose was 121.

Reactive Protein was 1.8 with normal 0.0-0.9

I think those were the main ones.

Hello JACustomer,

Was this random blood work? Did you fast prior to drawing this or had you eaten recently? Did you have blood work done because you were unwell? What prompted you to draw these tests? I know what each is, but the more information I have regarding your specific case the better my resultant answer will be.

Thank you so very much for clarifying,
Customer: replied 4 years ago.
Sorry. I sent that info. I don't know what happened to it. I was at my second visit to the rheumatologist. In January I suddenly started having joint issues. Prednisone made that better, but sporadically I still have issues of milder joint pain and swelling.
I went back this time mainly because I've become increasingly more fatigued throughout the summer and I've been having low grade fevers in the afternoons and evenings.
I had eaten a snack of apple chips about 30 minutes prior to the test.
Hello JACustomer,

Thanks for the details...the computer must have eaten it the first time you sent it. Its very helpful to try to put it all together.

I know you spent some time Googling this but I don't know your basic understanding here, so I am going to start simple. Lymphocytes and neutrophils are both types of white blood cells...cells that help the body fight disease. Each type of white blood cell is specialized to do different things. Neutrophils specialize in fighting off bacterial infections and lymphocytes "focus" is in fighting viral infections. Each different laboratory will have their own reference ranges.

My lab book gives the lymphocyte reference range as 25-40% of total leukocyte count or 1500-4000 cells/mm3. I do believe yours could be decreased though, as I am not sure what your reference range is. Decreased lymphocytes can be for many reasons. Reasons that make sense with your history include some immune disorders. There are other reasons as well, like lymphomas advanced debilitating illness, renal failure, anemia, chemotherapy, but most of these reasons don't appear to apply to you. (Though of course I cant state anything with any certainty; all I can do online is make an informed guess based on what you've written.

My lab book gives the value for neutrophils as 3000-7000/mm3 or 50-60% of the total white blood count. 78.5 is indeed high, and logical reasons in your case include inflammation. Increases here can occur due to bacterial illness, some infections, and some leukemias.

Your C-Reactive protein is high. That is a non specific marker of inflammation. It tells us that somewhere, something in your body is having an inflammatory response, but it does not tell us where or what.

I am pegging your mildly high blood sugar to both the apples you ate and the prednisone you are on, which can raise blood sugar.

My guess, looking at all of this, and considering your joint pain and fevers, is to wonder if you may have an autoimmune disease. I would ask your doctor about testing your Rheumatoid Factors and ANA, both are blood tests and they can tell if there is an autoimmune disorder; the pattern the ANA makes can in some cases tell which one.

I hope I was able to help here, and if you need any more advice, please don't hesitate to ask...and I hope you feel better soon.

Customer: replied 4 years ago.

Oh, something I wrote the first time that got lost is I got a positive ANA back in January, which is why I was sent to the rheumatologist. My rheumatoid factor this time was <4.Not sure what that means. Also, strangely, in January and March I had a sed rate of 42, and this time it was only 18.

Also, I'm not on prednisone anymore. I only did that for 10 days. But I suppose just the apples could have made my glucose high?

Does this change anything you said? I really appreciate your time and thorough answers! :)

Hello JACustomer,

Thank you so much for your kind words. They are very appreciated. The positive ANA reconfirms my suspicion that you may have an autoimmune disorder of some sort.

Your rheumatoid factor was less than 4; meaning less than 4 of the abnormal protein that most often accompanies rheumatoid arthritis was found in your blood.
Not all people with auto immune disorders will have a high RF as RF is geared pretty specifically to rheumatoid arthritis...though it does show up in other processes. What you can ask for is the ANA test to be repeated with phosphorescence; the patterns of the proteins will give more of a clue to what it is.

ESR (sed rate) is also a test of inflammation, and it to is non specific. 42 is definitely high; 18 is on the upper end of normal (my book has a cut off of 20).

Yes, apples could have raised your blood sugar for a brief while.

Prednisone acts as an anti-inflammatory agent, if you felt better on prednisone that to could be due to an auto immune disorder.

I hope that helped,
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