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What Causes High Lymphocyte Counts?

Posted on Mon, 13 Feb 2017

Question: My 2 yo son has an elevated wbc of 17.3. It was checked because a few months ago at another well child visit it was considered slightly elevated at 15. He has some shotty lymph nodes palpable (neck and groin) but none overtly enlarged. He has been well without any viral or sick symptoms otherwise at both checks. His total lymphocyte count is 11.00, lymphocyte percentage 63.8. His monocytes were flagged as high at 1.00 but I realize that is essentially normal. Granulocyte percentage was 30.1 which was flagged as low but very close to the cut off. Hemoglobin normal. Platelets normal. He does not necessarily bruise or bleed esily. Also the listed reference ranges I'm not sure are for a two-year-old. He has no medical problems outside of a mild case of eczema. What do you think is the cause of his increased white blood cell and lymphocyte count? I am very worried and would like to know if this is suspicious for leukemia or lymphoma. (The specimen was obtained via a finger-stick btw). Have you had patients present like this and what ultimately happened to account for the abnormal lab values? Thank you. By the way I am a dermatopathologist so medical details/ jargon welcome.

Answered by Dr. Hardik Sanghvi (40 minutes later)

Brief Answer:
Does not looks like leukemia.

Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.

He has high total count and high lymphocytes count.

High lymphocytes count is normal in pediatric age group. It is very common. Many children have 70 to 80 % lymphocytes count without any significant abnormalities. So it is not a cause of worry.

His total count is slightly high and it increased. But again it can be subclinical infection or other non specific cause.

In leukemia platelets count is generally low. Your son has normal count.

So in my opinion it doesn't looks like leukaemia.

Most of this types of patients don't have lymphoma. But it can be possibility.

In my opinion he should go for peripheral smear examination,serum LDH level and FNAC or biopsy of enlarged lymphnode. It will give you exact diagnosis.

Then plan accordingly.

Hope I have answered your all questions. If you have any doubts then feel free to ask me anytime. I will be happy to answered.

Thanks for using health care magic.
Wish you a very good health.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Hardik Sanghvi (38 minutes later)

Can you tell me what I should look for with serum LDH level? And do you think an in office collection is suffice or is there a difference in going to a legit lab? In this age group, would you recommend me getting it drawn over at a children's hospital so that they are familiar with the changes that can be seen in lymphocytes in this age group? thank you

Answered by Dr. Hardik Sanghvi (18 hours later)

Brief Answer:
LDH level increase in lymphoma.

Detailed Answer:
Hi, dear
I have gone through your question.
I can understand your concern.

LDH level increase in lymphoma. It not specific for lymphoma but it will help in diagnosis.

Blood collection by child hospital or home or laboratory doesn't make any difference. But it should be tested by qualified pathologist.

Qualified pathologist know it very well that what is normal for his age .

Hope I have answered your question. If you have any doubts then feel free to ask me.
I will be happy to answer.
Thanks for using health care magic.
Wish you a very good health.

Above answer was peer-reviewed by : Dr. Nagamani Ng