Can I get some advice about CBC results?

[alex57170]

Scared out of my mind. Someone I know just got platelet count in the middle 130's and I'm terrified for them. Someone close to me  between 50-60 years old. I can post further info about blood work. I know CBC won't help much but I'm trying to read the tea leaves and see what I can figure out. Any input qualified or not, is more than welcome. Thank you all!

I will probably be asking A lot of questions on here. I apologize in advance.

[Ken_PA]

Here, I found this one on youtube as an example of a very severe case. I mean it to show the difficulties in testing and diagnosis.

"How I Was Diagnosed with MCAS | Mast Cell Activation Syndrome Diagnosis, Criteria, Symptoms, Testing"

There's also an hour long one by Dr. Afrin, plus many others.

[Ken_PA]

Alex, I could write a thousand words and that would still not be enough when it comes to mystery immune system conditions. The immune system can do almost anything, the symptoms can be very varied. It often takes years to diagnose, and often patients are told it's mostly in their head or just plain anxiety.

Mast Cells have over a hundred receptors (sensors) and produce over two hundred powerful biochemicals. These following things immediately stand out to me as involving a possible Mast Cell disorder, such as MCAS:  

Memory fuzzy (brain fog)
use of anti-histamines (plural)
use of anti-inflammatory (pred)
hives, sometimes severe
even sleep apnea
frequent UTIs can be sterile interstitial cystitis, with no actual infection ever proven, yet antibiotics get prescribed

Then possible connective tissue attack by the immune system:
Plantar fasciitis    
arthritis in one knee

Overall, mystery immune system disorders are typically:  
mostly unexplained by Drs
typical allergy tests reveal nothing
Neurologists *guessing* but nothing is proven
still remain a mystery after a long time

Then also:
an esophagus problem, difficulty getting food down: possibly Eosinophilic Esophagitis (which is Mast Cells plus Eosinophils). A biopsy should be done, not merely *looking* with an endoscope.

Each specialist will see a symptom in isolation. But when seen in totality, it all fits together. The famous book by Afrin refers in its title to Occam's Razor, a principle in diagnosis which seeks to find a common cause in mystery cases. You can find a video lecture online.

The good news is it's not fatal like cancer. But it will take you tons of research to start to get a handle on it.

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Or else, speaking of the immune system, a tick borne disease can also do many mystery things. Lyme is the most infamous, but not the only, example of that.

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Asking for prayer would be offensive to me? No, it would be silly for me to get offended over that. :)






    

[alex57170]

I appreciate all the info! One more thing I feel is relevant, though not sure- this person is  fairly active- able to walk 0.7 to 2 miles a day for leisure. The median is about 1.4 miles, weather permitting.

I'll definitely look into that information.
Thank you!

[Ken_PA]

But still, even with that trend, a doc won't get alarmed and likely would merely say, "we'll keep an eye on it". That is justified. Numbers would have to be significantly out of range, and/or there would have to be some symptoms to correlate with.    

When you look around on the web, blood cancers might turn up at the top of the lists of possible causes, but that doesn't at all mean they are the most likely causes.  

Platelets would have to get much lower, roughly 50, before there might be easy bruising or bleeding.

[alex57170]

If you don't mind, I'm going to pm you the meds details  and partial medical history. No names of anyone or identifying info of course. Then if you like you can still post the reply here.

Thank you so much!

[alex57170]

One more thing before I log off, I don't know if this is appropriate or not to ask, but if you pray, would you keep her in your prayers? I would very much appreciate it and I hope this doesn't offend you me asking.

[Ken_PA]

Okay, that's new info. What's the age? Did they start taking any med then?

[Ken_PA]

Nothing worrisome there whatsoever. In fact, the usual platelet range is 150-450, while that particular machine has 140 as the lower limit. So the tested value of 136 is even more *slightly* out of range.

Here's how this goes: they take the tested values from the population and arbitrarily decide that the middle 95% or so are 'normal'. But even perfectly normal and healthy people can be and are out of the 'normal' range.

The next CBC might show a bit higher value, since there is some natural variance involved.

The WBC being lowish tends to say there is no infection. Actually, that also tends to say that their chronic inflammation is low, so the risk of heart attack etc is lowish. Are they very lean and active? Do they also have low hsCRP and low ESR tests?

Some people just have naturally low-normal WBCs. Unless they are prone to infections, then that low-normal WBC is desirable.

[alex57170]

Thank you! Yes they are active. Not lean nor, obese about average.  hsCRP and  ESR isn't something I think I have access to at the moment, but shall certainly look into it.

Also, there's a trend in their history on the CBC I've outlined in red- what about the consistent drop and the platelets going from 165 to 136 in approx. 18 months?
[see pic on profile]

[Ken_PA]

When a person has low platelets because of a blood cancer, the cause is that the bad cells are multiplying out of control within the marrow, and crowding out production of the normal cells. Production of normal is thereby decreased, and usually in all blood cell lines (white and red included with the platelets).

But a virus or other non-cancer causes  can result in destruction of platelets alone.

Glad to be of help :)

[Ken_PA]

"But she hasn't had a fever or been sick."
Probably most viruses don't result in fever.  E.g.,  a viral pneumonia won't, unless/until a bacteria then gets a foot hold. The idea is that any virus can provoke an immune reaction.

"...the CBC anyway? I'd rather not do it publicly."
Certainly, you can post it to your profile where people upload photos. Except of course you must blot out anything identifying, whether of patient or docs.

If lymphocytes are toward the high end of normal, that kinda tends to a virus.

[alex57170]

The CBC has been posted on profile, nothing identifying is there. I've been trying to read into this, so maybe you can find something I've missed. Thank you!

[Ken_PA]

Hi, Alex. No doc would think that this alone is significant. It's only very slightly low, and one time. Probably a virus.

No other blood cells are low. No doc would think this is a blood cancer.

[alex57170]

Thank you! But she hasn't had a fever or been sick. Could it be a virus without symptoms?  Can I pm you or email you the CBC anyway? I'd rather not do it publicly. Thank you again!