Question: I am 35 year old female that has been experiencing iron deficiency anemia and vitamin D deficiency for the past two years. I had an iron transfusion last year. I have been prescribed vitamin D three times. Currently, I am on 50,000u. I also have 3 esophageal ulcers. Recently, I was seen by my doctor due to a suspicion that my iron levels had dropped again ( I had begun to crave corn starch again). My PA did a CBC and a few other blood tests. Apparently, my lymphocyte count was high and after checking previous lab work he noted that my WBCs levels have been abnormal for the last two years. I am now scheduled to see a hematologist again tomorrow. I also have a eczema type rash on my left arm between my shoulder and elbow that has,continued to spread. I have never had eczema. The gland sin my neck are enlarged but not sore. I have not been sick at all besides headaches. My question is should I be concerned? Below are some of my most recent lab results. Not noted below is my low ferritin level, iron staturation and vitamin D.



WBC 3.5 x10(3)/mcL (3.0-10.3)
RBC 4.14 x10(6)/mcL (3.82-5.04)
Hemoglobin 12.4 g/dL (12.0-16.0)
MCV 87.0 fL (78-98)
MCH 30.0 pg (26.6-34.9)
MCHC 34.4 g/dL (33.0-36.5)
Platelets 189 x10(3)/mcL (150-440)
Neutrophils 28.5 Lower Than Normal % (42.5-75.1)
Lymphocytes 51.1 Higher Than Normal % (13.9-44.2)
Monocytes 5.5 % (3.5-12.7)
Eosinophils 13.8 Higher Than Normal % (0.0-6.6)
Basophils 1.1 % (0.0-1.9)
MPV 11.8 Higher Than Normal fL (7.0-11.0)
Hematocrit 36.0 % (35.0-46.0)
ABS Basophils 0.0 x10(3)/mcL (0.0-0.2)
ABS Eosinophils 0.5 x10(3)/mcL (0.0-0.5)
ABS Lymphocytes 1.8 x10(3)/mcL (0.7-2.8)
ABS Monocytes 0.2 Lower Than Normal x10(3)/mcL (0.3-0.9)
ABS Neutrophils 1.0 x10(3)/mcL (1.0-7.2)
RDW CV 12.9 % (10.7-14.6)
Ordering Provider: 45102 XXXXXXX XXXXXXX J
Ordering Location: 45th Medical Group
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Differential Chemistry/Hematology 18 Aug 2016 @ 1206


Test Name
Result
Units
Reference Range
Lymphocytes Atypical 3 % (0-10)
Normochromic YES
Normocytic YES
Platelet Estimate ADEQUATE
Neutrophils % 22 Lower Than Normal % (42.5-75.1)
Lymphocytes % 55 Higher Than Normal % (13.9-44.2)
Monocytes % 5 % (4.7-12.7)
Eosinophils % 14 Higher Than Normal % (0.0-5.0)
Basophils % 1 % (0.0-1.9)



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Thank you for your reply. The rash is recent (within the last year), but my eosinophils count has steadily increased since 2013. My lymphocytes have increased and overall WBC (was 8.0 in 2014) has continuously dropped since 2014. Additionally, should I not be concerned with the iron and vitamin D deficiency? I have never been on a diet (not vegan or vegetarian), do not have heavy menstrual cycles and get plenty of sun. What could cause the continued deficiencies and changes in my WBCs for years?