neutropenia

[danwest]

I am a male and have just been diagnosed with neutropenia:

wbc 4.0 (on the border of low)
neutophils 21 (real low)
lymphs 61 (real high)
eos 8 (a little high)
absolute neutrophils 0.8 (real low)

All my other blood work is good.

I have got a severe rash on my legs and arms the last few days that is really itchy.

I am not fatigued, exercise a lot,  or don't have a high fever, I have always bruised easily my entire life, had blood in urine, heart murmur and don't take any abnormal supplements (glucosamine, Q-10, fish oil and DHA), nose runs some mornings but only after I get up out of bed for a few mins.

I have gone through all the infections that can cause neutropenia according to the link http://www.merck.com/mmpe/print/sec11/ch132/ch132b.html and none of them seem to match up.

I am meeting with a hematologist soon, but wanted to know if anyone knew any possibilities?

thanks

[Evie1963]

I have thrombocytopenia (low platelet count, 59), Leucopenia and borderline Neutropenia (low white blood cell count) through liver disease. So I bruise and get petechiae hemorrhagingfrom things like tight jeans. Have you had a liver function test?

[bactitech]

Was there any morphology reported with your differential (what you have posted is the differential part of your CBC - complete blood count). What is your age? Elevated lymphocytes in adults can indicate a viral infection, but it also can portend other problems.

The hematologist will want a repeat CBC, and also MAY do a bone marrow examination, depending upon what your CBC shows. They will take a sample of marrow out of your hip. The marrow is where all your WBC's are made, and they can tell if something abnormal is going on with your WBC precursor cells.

Be sure to make a list of EVERYTHING you are taking, including any herbal stuff, vitamins, etc. Mark down dosages. The hematologist will take a thorough history. Mark down recent dates that you may possibly have been ill.

Have you been tested for HIV? They may test you for this, just to rule it out. I don't want to panic you, but a low WBC has many causes, and they will do the blood work they need to do to rule out certain conditions.

Blood in the urine in a male is an abnormal finding, although it may be exercise induced. Don't exercise the day before you go to the hematologist. Heavy exercise can cause blood in the urine, and you want to be able to tell if the blood goes away when you don't exercise.

Is your rash raised, or red dots on the skin? They may be petechiae, which can be indicative of many things. Keep an eye on these. Below is a definition. Do these sound like what you have?

http://www.medterms.com/script/main/art.asp?articlekey=4853

What was the rest of your CBC results? I'm assuming your hemoglobin/hematocrit were normal, as was the rest of your CBC. It's hard for lab people when they don't see the entire report :-). You've only posted a few parameters. Slightly elevated eosinophils can indicate an allergy, but I don't think an allergy would cause such an elevation in your lymphocyte count. The high lymphs and the low neutrophils are what is causing your doc to worry. What was your platelet count exactly? Low platelets can cause bruising. However, without seeing the entire report I'm just guessing. Normal platelets in most labs are 150-450,000.

I have been a medical technologist for 34 years. Although most of my life I have worked in microbiology I have trained in all areas of the laboratory and have worked in urinalysis and hematology, although it was many years ago.

Keep us posted and let us know what the hematologist says. Good luck.