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What Does This Blood Report Indicate?

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Posted on Mon, 23 Nov 2015
Question: Hi, I am concerned about my husband's last few cbc results. We see his internist tomorrow, and I would really love any input as to what these numbers could mean and what tests we should ask be done. His results are wbc 19.5, absolute neuts 14.9, absolute monocytes 1.5. WBC morphology showed tox gran, absolute imm gran .5. He was treated with antibiotics for a month - after 2 weeks there was a slight decrease in wbc count (to 15), but after the full 4 weeks all his counts are back up to at least the original levels or more. A c-reactive protein test showed a result of 3.0 mg. Can you please provide insight to these numbers, and any suggestions for testing that should be done? He is fatigued, has back pain and is treated for high cholesterol. His father has a form of chronic leukemia (I am not sure which kind). I am specifically worried about cancer. Thank you for your help and time.
doctor
Answered by Dr. Indu Kumar (5 hours later)
Brief Answer:
His findings may be due to infecion etc.

Detailed Answer:
Hello

Your husband's findings may suggests raised WBC(neutrophil)count,immature granulocytes,toxic granules in WBC etc.
Immature neutrophils(WBC) in blood may be increased in infection,inflammation,necrosis etc.
It is important to know presence of myeloblast cells(immature granuocytes).
His findings may be due to infection,cancer etc.
Normal RBC count and not much raised WBC count are against cancer.
Toxic granules in WBC may be seen in conditions like severe infection,sepsis etc.
Raised monocyte count may be due to infection,cancer etc.
Increased CRP also indicate towards infection/inflammation.

Your husband need proper clinical evaluation and further tests due to family history and his age.

He may also need follow up of renal tests as BUN is raised and creatinine is towards upper limit.

He should also avoid fatty and fried food due to raised triglyceride level.

Get well soon.
Hope I have answered your query.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Indu Kumar (25 minutes later)
Thank you. I know he needs further testing, my initial question was asking WHAT tests you would recommend specifically. He has an appointment tomorrow and I want to make sure that all proper and necessary tests are done. To summarize, I would like to know, please:

1. WHICH specific tests you would recommend be performed (ie PET scan, Bone Marrow, renal blood test repeat etc) next?

2. His absolute imm gran is increasing currently at .1 THOU/CU MM. What does this mean - isn't this the immature granuocyte count? What is this indicative of, and why is it important to know?

3. What do you think, based on the limited information presented, is going on - and how do his BUN and Creatine levels impact the bigger picture, if at all?

Thank you for your time and help.
doctor
Answered by Dr. Indu Kumar (9 hours later)
Brief Answer:
He may need proper work up for infection.

Detailed Answer:
Hello
Sorry for replying late

Initially your husband may need proper work up for infection as infection is most likely reason for such findings.
He may need ultrasound of abdomen,chest X-ray (PA view),blood culture,urine RE/ME etc.
Bone marrow may be advised after clinical evaluation.

It is important to see for type of immature cells in blood smear.Immature granulocytes like metamyelocytes,myelocytes and promyelocytes may be normally seen in blood.It is important to see for blast cells which may indicate malignancy.

Raised creatinine level may indicate renal disease.Increased BUN may be due to many causes like infection,dehydration etc.
Ultrasound of abdomen is also helpful in assessing kidney condition.It is good that GFR is normal.
He may only need regular follow up for kidney findings.

Get well soon.
Hope I have answered your query.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Indu Kumar

Radiologist

Practicing since :2004

Answered : 6728 Questions

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What Does This Blood Report Indicate?

Brief Answer: His findings may be due to infecion etc. Detailed Answer: Hello Your husband's findings may suggests raised WBC(neutrophil)count,immature granulocytes,toxic granules in WBC etc. Immature neutrophils(WBC) in blood may be increased in infection,inflammation,necrosis etc. It is important to know presence of myeloblast cells(immature granuocytes). His findings may be due to infection,cancer etc. Normal RBC count and not much raised WBC count are against cancer. Toxic granules in WBC may be seen in conditions like severe infection,sepsis etc. Raised monocyte count may be due to infection,cancer etc. Increased CRP also indicate towards infection/inflammation. Your husband need proper clinical evaluation and further tests due to family history and his age. He may also need follow up of renal tests as BUN is raised and creatinine is towards upper limit. He should also avoid fatty and fried food due to raised triglyceride level. Get well soon. Hope I have answered your query. Further queries are most welcome. Take Care Dr.Indu XXXXXXX