CBC Results Showed High Lymphocytes, High Neutrophils And Low Neutrophil Count. Any Suggestion?

Posted on Thu, 28 Feb 2013

Question: Can you please interpret my latest CBC results? My lymphocytes are almost as high as my neutrophils and my absolute neutrophil count is low

Component     Your Value     Standard Range     Units
White Blood Cells     4.4     4.0 - 11.0     K/uL
RBC     4.93     4.30 - 5.70     M/uL
Hemoglobin     15.1     13.7 - 16.7     g/dL
Hematocrit     44.6     40.0 - 50.0     %
MCV     90.5     80.0 - 100.0     fL
MCH     30.6     27.0 - 34.0     pg
MCHC     33.9     32.0 - 37.0     g/dL
RDW     12.1     11.0 - 15.0     %
Platelets     170     150 - 400     K/uL
Differential Type     SEE COMMENTS
AUTOMATED DIFF PERFORMED
Neutrophils %     43.6     40.0 - 80.0     %
Immature Granulocytes     0.9     0.0 - 1.0     %
Lymphocyte %     40.6     15.0 - 45.0     %
Monocyte %     11.1     0.0 - 12.0     %
Eosinophils %     3.6     0.0 - 7.0     %
Basophils %     0.2     0.0 - 2.0     %
Nucleated RBCs     0.0          /100 WBCs
Reference range: 0.0 to 0.9
Neutrophils,Absolute     1.92     2.00 - 7.30     K/uL
Immature Granulocytes Abs,     0.04     0.00 - 0.05     K/uL
Lymphocytes Absolute     1.79     1.00 - 3.40     K/uL
Monocytes Absolute     0.49     0.00 - 0.80     K/uL
Eosinophils Absolute     0.16     0.00 - 0.50     K/uL
Basophils Absolute     0.01     0.00 - 0.10     K/uL

Answered by Dr. Dipanjan Majumder (1 hour later)

Hi XXXXXXX

Thanks for asking your queries at XXXXXXX forum. You have mentioned little about your clinical history. I want to know some information.
- have you suffered from fever recently?

- have you noticed any blood spots on anywhere in your body?
-do you feel very weak?
-do you have any complain like exertional breathlessness?
- have you got any swelling anywhere in your body?

Please mention why your doctor asked for a complete hemogram. Anyway, your present hemogram is within normal limit. Nothing abnormal finding can be traced. Please ask me if you have any specific query. I will be available to answer.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Dipanjan Majumder (1 hour later)

Hi Dr. Majumder,

- No. The last time I had a fever that I'm aware of was back in July 2012.
- I have had tiny red spots, about the size of the point of a needle. They are fairly few and far between and I've had these for years. They start as red then get darker and go away.
- No
- Not really, but I've been feeling more tired than usual lately. Also when I lay down, after a few minutes my heart rate will go up. That said, I've had more anxiety lately about my health so I don't know whether those things are caused by the anxiety.
- I do have two palpable lymph nodes on the left side of my neck I think they said were posterior cervical. One is about 1-1.5 cm and is a rubbery consistency. The other is less than 1 cm and is more a soft consistency. I first noticed the larger one while palpating my neck. It has not seemed to have grown in size since I first noticed it back in mid-December 2012.

i don't know why my doctor ordered these values in particular but he has done so each time a CBC has been done. After this CBC he mentioned the mild low absolute neutrophil count because over several CBCs it has ranged around 2.

Answered by Dr. Dipanjan Majumder (3 hours later)

Hi XXXXXXX
Thank you for posting your queries. Now first I want to mention that your absolute neutrophil count is decreased slightly. If you have no additional feature I will not think this is significant. Now the history of spots is to be evaluated. there is an immense scope of clinical examination. Nature, site, size, surface, duration are to be noted. have you got any episode of bleeding thorough any orifice? have you got any history of bleeding for prolonged time? probably your doctor has asked you for CBC for this reason. At present, in my opinion platelet aggregometry may be a choice.Can you please mention your urine routine and microscopic examination report. It will be helpful to have a ESR report also. You may repeat your CBC after one month to assess the trend of your neutrophil count. Consult your doctor regarding these issue. please send me if you have further query. I will be available to answer.

Note: For further queries related to kidney problems Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar