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Diagnosed GERD And IBS. Blood Test Showed Presence Of Anti TPO - And Elevated T Cells. Thyroid Problem Or Another Autoimmune Problem?
Question: Hi - I have been feeling unwell for past 18 months. Have been diagnosed GERD and IBS after abdo CT and MRI, edoscopy and colonoscopy. Recent blood tests show presence of Anti TPO -, elevated T Cells, high MCH and MCV but Hb normal. Also IgE way above normal. Recent ultrasound on Thyroid - hyperemia and cysts. Could I have a thyroid problem or another autoimmune problem? Are the high levels of T Cells worth further investigation & what would be the type of tests to run?
Hello and thank you for sending your question.
Your question is a very good one and I will work on providing you with some information and recommendations.
I can sympathize with the fact that you have been feeling quite sick for a long long time. Hopefully your doctors are in the process of getting to the bottom of this so that eventually you can feel back to normal.
The presence of TPO antibodies in your system does suggest that you have an autoimmune process causing a problem with your thyroid gland. This may increase the risk of future thyroid problem and it does indicate that your doctors will need to follow your thyroid gland function very carefully.
The elevated MCV may be just a normal variant but it would be a good idea for your doctor to check your vitamin B12 and folate levels to see if that might be contributing to the laboratory findings.
What test indicated elevated T cells? If you can attach a copy of the laboratory report this might be more helpful.
The elevated IgE is somewhat nonspecific and can sometimes be related to allergies infections or autoimmune processes.
Thank you again for sending your question. Again if you send a copy of the letter to report this might be more helpful for us to interpret.
Again I hope you remain optimistic that eventually you will feel better.
Sincerely,
Dr. Galamaga
Your question is a very good one and I will work on providing you with some information and recommendations.
I can sympathize with the fact that you have been feeling quite sick for a long long time. Hopefully your doctors are in the process of getting to the bottom of this so that eventually you can feel back to normal.
The presence of TPO antibodies in your system does suggest that you have an autoimmune process causing a problem with your thyroid gland. This may increase the risk of future thyroid problem and it does indicate that your doctors will need to follow your thyroid gland function very carefully.
The elevated MCV may be just a normal variant but it would be a good idea for your doctor to check your vitamin B12 and folate levels to see if that might be contributing to the laboratory findings.
What test indicated elevated T cells? If you can attach a copy of the laboratory report this might be more helpful.
The elevated IgE is somewhat nonspecific and can sometimes be related to allergies infections or autoimmune processes.
Thank you again for sending your question. Again if you send a copy of the letter to report this might be more helpful for us to interpret.
Again I hope you remain optimistic that eventually you will feel better.
Sincerely,
Dr. Galamaga
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
The t cells were part of the white cell count: Details below
March 2013
CD3 (Pan T cells) absolute count 2.48 - ref range (0.90-2.10) *these are measured 10 to power of 9/L
CD4 (T helper cells) absolute count 1.83 - ref range (0.60-1.70)
CD4/CD8 ratio - 2.8
Lab noted that increased helper cells could be reactive process
XXXXXXX 2013
CD3 - 2.19 * these are measured 10 to power of 9/L
CD4 - 1.59
CD/CD8 Ratio 2.8
Red cell count
April 2013
Hb 130 - ref range (115 -165)
MCV 99 - ref range (80-100)
MCH 33.2 - ref range (27-33.0)
Platelets 177
XXXXXXX 2013
Hb 139
MCV 100
MCH 33
Platelets 166
My serum b12 is within normal limits (494pmol/L) and my serum folate at 1347 is quite high. I am being tested for parietal antibodies and intrinsic factor to see if I have Pernicious aenemia.
My ESR is not elevated and CRP not elevated.
All other antibodies negative
Very high allergy response to Australian native plants (too bad I live in Austalia!)
March 2013
CD3 (Pan T cells) absolute count 2.48 - ref range (0.90-2.10) *these are measured 10 to power of 9/L
CD4 (T helper cells) absolute count 1.83 - ref range (0.60-1.70)
CD4/CD8 ratio - 2.8
Lab noted that increased helper cells could be reactive process
XXXXXXX 2013
CD3 - 2.19 * these are measured 10 to power of 9/L
CD4 - 1.59
CD/CD8 Ratio 2.8
Red cell count
April 2013
Hb 130 - ref range (115 -165)
MCV 99 - ref range (80-100)
MCH 33.2 - ref range (27-33.0)
Platelets 177
XXXXXXX 2013
Hb 139
MCV 100
MCH 33
Platelets 166
My serum b12 is within normal limits (494pmol/L) and my serum folate at 1347 is quite high. I am being tested for parietal antibodies and intrinsic factor to see if I have Pernicious aenemia.
My ESR is not elevated and CRP not elevated.
All other antibodies negative
Very high allergy response to Australian native plants (too bad I live in Austalia!)
Hello again,
On review of your white blood cell profile it appears the CD3 and CD4 are just at the upper limits of normal. This can be followed conservatively but should be rechecked again perhaps in 6 months.
It is reasonable to check for the pernicious anemia but I would expect your hemoglobin to be much lower if that were the case. at 13.9 g/dL your hemoglobin is essentially normal. Do you know what your total white blood cell count is? This is usually between 4 and 12 and should also come with a differential of percentage of neutrophils and lymphocytes and is normally part of a CBC test.
If the results are still not clear a referral to a hematologist may be reasonable and a consideration of a bone marrow biopsy may be discussed but at this point is not indicated.
Thanks again and let me know if you have any additional questions or information.
Sincerely,
Dr. Galamaga
On review of your white blood cell profile it appears the CD3 and CD4 are just at the upper limits of normal. This can be followed conservatively but should be rechecked again perhaps in 6 months.
It is reasonable to check for the pernicious anemia but I would expect your hemoglobin to be much lower if that were the case. at 13.9 g/dL your hemoglobin is essentially normal. Do you know what your total white blood cell count is? This is usually between 4 and 12 and should also come with a differential of percentage of neutrophils and lymphocytes and is normally part of a CBC test.
If the results are still not clear a referral to a hematologist may be reasonable and a consideration of a bone marrow biopsy may be discussed but at this point is not indicated.
Thanks again and let me know if you have any additional questions or information.
Sincerely,
Dr. Galamaga
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. Chakravarthy Mazumdar
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