

Question:
Brief Answer:
WBC indicate active infection. symptoms details needed.
Detailed Answer:
Hello and welcome to Ask A Doctor services.
I have evaluated your attached reports of bone marrow.
* As per the report, there are many white blood cells indicative of active
infection which may be due to various reasons.
For complete understanding, kindly provide further details of current symptoms, past history and your queries so that I can answer your query precisely.
Thank you.
Regards.
Dr Bhagyesh ( MS consultant surgeon )
WBC indicate active infection. symptoms details needed.
Detailed Answer:
Hello and welcome to Ask A Doctor services.
I have evaluated your attached reports of bone marrow.
* As per the report, there are many white blood cells indicative of active
infection which may be due to various reasons.
For complete understanding, kindly provide further details of current symptoms, past history and your queries so that I can answer your query precisely.
Thank you.
Regards.
Dr Bhagyesh ( MS consultant surgeon )
Above answer was peer-reviewed by :
Dr. Vaishalee Punj


It started in Feb 2017 with bilateral optic neuritis, followed by small fiber neuropathy, B12 deficiency, autonomic neuropathy, POTS, a right bundle branch block, Central sensitization syndrome, another diagnosis of bilateral optic neuritis, followed by skin lesions that have been diagnosed as rosacea but treatment appears to be making it worse. The first week of January I developed a fever that gets worse as the day progresses, peaking around 102 before bed and is back to normal by morning. I've lost 30 pounds in about 8 months without trying. I am more exhausted than you would think is possible all the time, I have recently developed Renaud's, the longer I'm up and moving around the more my feet, ankles and hands swell up, I have 87% anhydrosis, exercise intolerance, and if I get too hot or stand up too quickly I pass out.
All of the other tests have been negative for bacterial or fungal infections, autoimmune, and paraneoplastic syndromes have been negative. The first LP had 29 WBC but no O bands and those had resolved by the second LP six months later in 2017.
Really I just want to know why one said many WBC and the other said 21%. How can one test say many and the other say almost not enough?
All of the other tests have been negative for bacterial or fungal infections, autoimmune, and paraneoplastic syndromes have been negative. The first LP had 29 WBC but no O bands and those had resolved by the second LP six months later in 2017.
Really I just want to know why one said many WBC and the other said 21%. How can one test say many and the other say almost not enough?

Oh, and rather excruciating pain deep in my thighs and elbows that goes half way up and down my arms that's a burning ache. I used to only notice it when I was not doing anything else but lately it is constant and way worse and seems to be moving up into my hips and lower spine.
Brief Answer:
follow up .
Detailed Answer:
Hi XXXXXXX
Welcome for the follow up and thanks for the relevant details.
* The LCMS ( Liquid Chromatography Mass Spectrometry ) is advanced
technique of separation procedure for the individual components of a liquid
or content with mass analysis and that is why it can reveal much details in
% ratio as shown in results as 21 % Lymphocytes ( type of white blood
cell ).
Absence of pre mature cells suggest that there are no cancer precursor or
other anomaly in that range so far.
* While gram stain facility has not such capability and it depicts only
presence and absence of cells or material depending upon the staining
characteristics.
And this is the basic cause of difference between the two interpretations.
Thank you.
follow up .
Detailed Answer:
Hi XXXXXXX
Welcome for the follow up and thanks for the relevant details.
* The LCMS ( Liquid Chromatography Mass Spectrometry ) is advanced
technique of separation procedure for the individual components of a liquid
or content with mass analysis and that is why it can reveal much details in
% ratio as shown in results as 21 % Lymphocytes ( type of white blood
cell ).
Absence of pre mature cells suggest that there are no cancer precursor or
other anomaly in that range so far.
* While gram stain facility has not such capability and it depicts only
presence and absence of cells or material depending upon the staining
characteristics.
And this is the basic cause of difference between the two interpretations.
Thank you.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj


From what information I can find, the normal range is 20-40%. How can one test say many while the other says barely normal?
Brief Answer:
follow up.
Detailed Answer:
Hi
Thanks for the follow-up.
* The standard reference range guideline provided by the international
protocol of different lab data value and the same can be found out via
particular website of the institute or on request via the information desk of the
same.
But again the results of gram stain and LCMS method can not be compared as the basic parameters of both are different and you should not cross-match the data of quantitative assay with the qualitative assay in clinical terms.
Regards
follow up.
Detailed Answer:
Hi
Thanks for the follow-up.
* The standard reference range guideline provided by the international
protocol of different lab data value and the same can be found out via
particular website of the institute or on request via the information desk of the
same.
But again the results of gram stain and LCMS method can not be compared as the basic parameters of both are different and you should not cross-match the data of quantitative assay with the qualitative assay in clinical terms.
Regards
Note: Do you have more questions on diagnosis or treatment of blood disorders? Ask An Expert/ Specialist Now
Above answer was peer-reviewed by :
Dr. Arnab Banerjee

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