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What Does This Following Blood Report Indicate?

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Posted on Tue, 23 May 2017
Question: Recently I had knee surgery because I had a necrotic defect in my knee and it broke off into 6 pieces and the had to remove the loose bodies. When I was talking to the physical therapist they asked me about pain. I told them I have a lot of bone pain. Especially at night. It is the worst in my upper legs/especially knees and upper arms and elbows. It is a deep ache. I have a history of chronic pain in muscles and sometimes joints, but this is different. Its been consistent for 2+ months. The PT said they ask about pain at night because that can be a sign of cancer and that I should mention it to my doctor.
1. I was just curious why cancer causes night pain?

Also, about 2 years ago I was diagnosed with low ferritin. My doctor tried iron infusions but I got sick from them. He said my other iron levels were fine, just a low ferritin. Is this a concern at all if my other numbers are ok? What causes only the ferritin to be low?
Below is a blood smear from a year ago. Is anything abnormal/concerning on here? What is rouleaux formation?

Peripheral Blood Smear:     Red Blood Cells: Normocytic, normochromic. Few ovalocytes and mild rouleaux formation.
White Blood Cells: Decreased in number. Monocytes with cytoplasmic vacuolization.
Platelets: Normal in number, few large giant forms.
Impression: Mild anemia and leukopenia. Correlate with serum protein studies.


This is my most recent labs from March

WBC     2.9 10E3/uL     4.8 - 10.8 10E3/uL
RBC     3.74 10E6/uL     4.00 - 5.40 10E6/uL
Hemoglobin     12.2 g/dL     12.0 - 16.0 g/dL
Hematocrit     35.7 %     35.0 - 47.0 %
MCV     95.5 fL     80.0 - 99.0 fL
MCH     32.6 pg     27.0 - 34.0 pg
MCHC     34.2 g/dL     31.0 - 37.0 g/dL
Platelets     234 10E3/uL     130 - 400 10E3/uL
MPV     9.3 fL     8.0 - 13.0 fL
RDW     12.3 %     11.0 - 16.0 %
Neutrophil Percent     44.7 %     37.0 - 75.0 %
Lymphocyte Percent     42.7 %     14.0 - 48.0 %
Monocyte Percent     7.5 %     0.0 - 12.0 %
Eosinophil Percent     4.4 %     0.0 - 6.0 %
Basophil Percent     0.7 %     0.0 - 2.0 %
Immature Granulocytes Percent     0.0 %     0.1 - 0.3 %
Neutrophil Number     1.3 10E3/uL     2.0 - 8.0 10E3/uL
Lymphocyte Number     1.3 10E3/uL     0.7 - 5.2 10E3/uL
Monocyte Number     0.2 10E3/uL     0.1 - 1.3 10E3/uL
Eosinophil Number     0.130 10E3/uL     0.150 - 0.300 10E3/uL
Basophil Number     0.020 10E3/uL     0.000 - 0.210 10E3/uL
IMM GRAN Number     0.00 10E3/uL     0.01 - 0.03 10E3/uL

Ferritin     6 ng/mL
Iron     132 mcg/dL     50 - 212 mcg/dL
Transferrin     269.0 mg/dL     203 - 362 mg/dL
Iron % Saturation     39 %     15 - 50 %
TIBC     336.25 ug/dL
doctor
Answered by Dr. Deepak Sundriyal (1 hour later)
Brief Answer:
There is nothing to worry

Detailed Answer:
Hello dear. I have gone through the details.

So all of your reports seems normal except a mildly low WBC count and low ferritin. The Wbc count can be low sometimes due to differential rates of production and destruction of cells.

Low ferritin represents that you have inadequate stores of iron but not necessarily anemia as you have a borderline low hemoglobin. So you need not take the iron injection. Only the iron tablets are sufficient to restore the iron stores.

Moreover, night pain in bones is only present in bone cancers and does not mean that the person has cancer always.

It can also be seen in osteoporosis and osteomalacia which are metabolic and nutritional Deficiency bone disease.

So there is nothing to worry. Let me know if I can assist you further.
Thanks and regards

Note: For further queries related to kidney problems Click here.

Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Answered by
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Dr. Deepak Sundriyal

Oncologist

Practicing since :2005

Answered : 1655 Questions

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What Does This Following Blood Report Indicate?

Brief Answer: There is nothing to worry Detailed Answer: Hello dear. I have gone through the details. So all of your reports seems normal except a mildly low WBC count and low ferritin. The Wbc count can be low sometimes due to differential rates of production and destruction of cells. Low ferritin represents that you have inadequate stores of iron but not necessarily anemia as you have a borderline low hemoglobin. So you need not take the iron injection. Only the iron tablets are sufficient to restore the iron stores. Moreover, night pain in bones is only present in bone cancers and does not mean that the person has cancer always. It can also be seen in osteoporosis and osteomalacia which are metabolic and nutritional Deficiency bone disease. So there is nothing to worry. Let me know if I can assist you further. Thanks and regards