hi yes please im a doctor in icu and recently we admitted a case of 67 y old lady known hypertensive.history of colostomy 3 weeks ago.she had very severe transfusion reaction when receving a packed RBCs as her hg level was 7.her reaction was so severe that she complicated by pulmonary edema.anaphlactic shock.required mechanical ventilation.received solumedrol for 3 days then shifted to solucortef now.CVP now 22.low urine out put.her TLC count is now 170000 which was repeated in different labs.why is this VERY HIGH TLC COUNT??and what treatment u suggest for her?knowing that TLC before transfusion was 11000.patient is deteriorating confused.please advise me.great thanks.dr.ehab
Hello and welcome to HCM, High TLC can occur in cases of infection, inflammation and neoplasms. A differential count is required to know the cause of high TLC. Thus, you need to get a peripheral blood smear to know the differential count and the component of the white cells which is increased. Infections can cause elevated TLC, however, the TLC upto this level is not seen infections. Neoplasm or leukemia is most probable cause of high TLC. Thus peripheral blood smear examination and flowcytometry is the investigation required to know the cause of elevated TLC. Further management depends on the diagnosis of this condition.
Thanks and take care Dr Shailja P Wahal
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What Causes High TLC Count?
Hello and welcome to HCM, High TLC can occur in cases of infection, inflammation and neoplasms. A differential count is required to know the cause of high TLC. Thus, you need to get a peripheral blood smear to know the differential count and the component of the white cells which is increased. Infections can cause elevated TLC, however, the TLC upto this level is not seen infections. Neoplasm or leukemia is most probable cause of high TLC. Thus peripheral blood smear examination and flowcytometry is the investigation required to know the cause of elevated TLC. Further management depends on the diagnosis of this condition. Thanks and take care Dr Shailja P Wahal