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What Causes High Monocytes And WBC Count?
Question: July 9th ultrasound showed enlarged spleen at 14.5 cm and fatty liver. Had ct scan on July 16th with die and contrast on abdomen and pelvic area. Told all organs normal size and nothing significant found. Is ct more accurate? Gastro did liver panel, auto immune, hepatitis tests, XXXXXXX test. All normal but ALt at 73. CBC is all normal except for absolute and % monocytes absolute 1.1, and10.5. lympho% low at 21.5 but absolute lymph normal. total wBC 10.4. All other blood work normal. Neither my family doctor or the gastro seem concerned and told me to follow up in 6 months. Problem is if I take my fingers and put them just below my ribcage or a little under it and take a deep breath I can feel a lump push on my fingers. I assume this is my spleen and I should not feel this correct? Family doctor did not feel spleen and said If I push up under ribs and breath it probably is my spleen but no big deal. She said the ct is very accurate and spleens can vary in size I am not a huge guy but am 210 standing 5'9. With monocytes high and total wBC slightly higher I am concerned they miht be wrong and are shrugging this off. Just looking for another opinion and should I be concerned even though they are not? Thank you in advance!
Brief Answer:
CT is operator independent and more reliable
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
I have read through your query in detail.
The normal adult splenic length upper limit is usually around 12 - 15 cms. This often depends on the patient and the person who is measuring. At 14.5 cm, for some it might be enlarged and for few it is normal. CT is less operator dependent and said to be more accurate when in doubt.
I have come across few patients with spleen measuring 14 - 15 cm and having no significant underlying condition.
The causes of an enlarged spleen are as follows
haematological disease
haemodynamic
infectious
storage diseases / metabolic diseases
neoplastic (non-haematologic)
traumatic
connective tissue disorders
In most hematological diseases, the blood cell counts should be times higher. Mild elevation is not a concern. I suppose your peripheral blood smear is also normal and that rules out any blood disorders.
The spleen, when enlarged, grows towards the right lower abdomen. If in the coming weeks you feel that there is a lump growing in that fashion then you can consult your doctor earlier.
Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
CT is operator independent and more reliable
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
I have read through your query in detail.
The normal adult splenic length upper limit is usually around 12 - 15 cms. This often depends on the patient and the person who is measuring. At 14.5 cm, for some it might be enlarged and for few it is normal. CT is less operator dependent and said to be more accurate when in doubt.
I have come across few patients with spleen measuring 14 - 15 cm and having no significant underlying condition.
The causes of an enlarged spleen are as follows
haematological disease
haemodynamic
infectious
storage diseases / metabolic diseases
neoplastic (non-haematologic)
traumatic
connective tissue disorders
In most hematological diseases, the blood cell counts should be times higher. Mild elevation is not a concern. I suppose your peripheral blood smear is also normal and that rules out any blood disorders.
The spleen, when enlarged, grows towards the right lower abdomen. If in the coming weeks you feel that there is a lump growing in that fashion then you can consult your doctor earlier.
Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you very much doctor, the information is very helpful. I was just concerned since the WBC count was a little high. Since the spleen processes the blood I thought it might be connected. Yes the blood smear, RBC, plt, hgb, hct, MCV, mch, mchc, iron, and tibc normal range.
I am seeing an ENT on Tues because I seem to have inflamed tonsils a lot that causes infections. Checking to see if they need to be removed due to inflammation, craters, and tonsil stones. Could this increase my wbc and cause problems with the spleen maybe? Similar to mono? Again thank you for your time, and it seems like you feel similar to my other two doctors. The piece of mind and verification helps with another opinion! Thank you Doctor!
I am seeing an ENT on Tues because I seem to have inflamed tonsils a lot that causes infections. Checking to see if they need to be removed due to inflammation, craters, and tonsil stones. Could this increase my wbc and cause problems with the spleen maybe? Similar to mono? Again thank you for your time, and it seems like you feel similar to my other two doctors. The piece of mind and verification helps with another opinion! Thank you Doctor!
Brief Answer:
WBC count elevation due to tonsillitis
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
Tonsils are the gateway to the body and the tonsillar pillars are like security guards. Any infection or inflammation in the tonsils causes increase in white blood cell count.
Infectious mononucleosis usually affects in the age group 10 - 30 years and presents with problems in the tonsil with a mildly enlarged spleen infrequently. Usual tonsillitis does not have splenomegaly.
Though this can cause rise in WBC by a certain level, it is unlikely to impact your spleen size. Some people are born with a slightly larger spleen and you might be one among them.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
WBC count elevation due to tonsillitis
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
Tonsils are the gateway to the body and the tonsillar pillars are like security guards. Any infection or inflammation in the tonsils causes increase in white blood cell count.
Infectious mononucleosis usually affects in the age group 10 - 30 years and presents with problems in the tonsil with a mildly enlarged spleen infrequently. Usual tonsillitis does not have splenomegaly.
Though this can cause rise in WBC by a certain level, it is unlikely to impact your spleen size. Some people are born with a slightly larger spleen and you might be one among them.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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