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What Do Slight Macrocytosis And Slight Anisocytosis Mean While Having Low White Blood Cells With Low Platelets?

Posted on Wed, 23 Nov 2022

Question: I had recent CBC . I have low white blood cells and low white blood cells with low platelets. Hemoglobin is normal as well as lymphocytes. Morphology review showed slight macrocytosis and slight anisocytosis. Everything else is in the normal range. What could this mean?

Answered by Dr. Panagiotis Zografakis (12 minutes later)

Brief Answer:
Please upload the report!

Detailed Answer:

Hello,

lab tests can be interpreted only within a clinical context, so I'd like you to inform me about the following:
- Why did you do the tests? Was it a check-up? Did/do you have any symptoms?
- I'd like to see the report itself as "low-high" may be interpreted differently depending on how high or how low they are.
- have you done any other tests?

Please upload the test reports. It will be very helpful for me.

Regards

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

Follow up: Dr. Panagiotis Zografakis (27 minutes later)

WBC 3.5 10*3/uL
RBC 3.50 10*6/uL
Hemoglobin 14.0 g/dL
Hematocrit 40.3%
MCV 115.0 fl
MCH 40.0 pg
MCHC 34.8 g/dL
Platelet 102 10*3/uL
Mean Plat. Volume 8.3 fL
SEG% 50%
Band Neutrophil % 1%
Lymphocyte% 34%
Monocyte % 8%
EOS Percent 5%
Basophil 2%
ABS. Neutrophil CT. 1,785/uL
Morphology ABNORM
Macrocytosis SLIGHT
Anisocytosis SLIGHT

COMMENT
PLT Morphology Normal
WBC Morphology Normal

I did this test because I was very fatigued and I was bruising easily. I also had
not taken my prescibed folic acid for about 6 weeks prior to the blood work and I do drink about 4-5 glasses of wine daily. ( I know this is not good)

Thank you

Answered by Dr. Panagiotis Zografakis (9 minutes later)

Brief Answer:
it may indicate nutrient deficiencies and/or liver damage, etc

Detailed Answer:

Hi,

If you've had a low folic acid level then this is adequate explanation for these findings on its own. Drinking so much alcohol (and being a woman which means that you're more sensitive to alcohol induced damage than men) may affect your liver and lower your B12 vitamin which may also cause the same findings. The macrocytosis is probably a result of nutrient deficiency (folic acid and/or vitamin B12). Low platelets may have occurred either due to nutrient deficiency and/or liver damage (hypersplenism).

I would suggest measuring your B12 and folic acid levels and start taking supplements if required. If there are signs of liver insult (like elevated transaminases or ultrasound findings suggestive of cirrhosis), then treating the liver disorder and cutting down on alcohol should be your main aim.

If none of the above apply to you then consulting a hematologist might be the most appropriate next step. Macrocytosis (high MCV) is the prominent finding that requires investigation.

I hope you find my comments helpful!

Regards

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

Follow up: Dr. Panagiotis Zografakis (10 minutes later)

I also have been diagnosed with Hashimoto's Thyroditis for about 10 years and am
taking Levothyroxine. b12 was ok.

Answered by Dr. Panagiotis Zografakis (4 minutes later)

Brief Answer:
It has to be folic acid or liver insult then

Detailed Answer:

Hi,

Hashimoto's cannot cause such findings. Since B12 was OK, you should check your folic acid levels unless you've done so and they're indeed low. In that case, supplementation with folic acid should start right away. 1mg of folic acid per day should be enough.

The liver should be checked as well starting with the tests I've suggested.

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. Chakravarthy Mazumdar