lymphocyte count borderline low

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24 January 2016 at 7:58 pm #10311
dointime
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@dointime
My recent bloods show my lymphocyte count = 1.22. According to the range of the test, this is just above the borderline for LOW.
Before I started tx this count was always higher, eg. in the last year it has been, 2.37, 1.77, and 1.98.

So my questions are:
– is a decrease in the lymphocyte count to be expected on tx?
– if not, is this value something I should be concerned about?

thanks,
dt
24 January 2016 at 8:32 pm #10313
dointime
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@dointime
Could it be because I took cetrizine as a rash preventitive? My monocytes are a bit lower too.

http://www.ncbi.nlm.nih.gov/pubmed/7751519

dt
25 January 2016 at 6:10 am #10354
Ariel
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@ariel
Hi dointimme have you had a film bloods done to look at the morphology of your lymohocytes? Sorry to hear this is happening I would ask a doc to look into it x
25 January 2016 at 12:58 pm #10370
Dr James
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@fixhepc
Hello DT – on the face of it I would not be overly worried.

Could you post the full results?

Ribavirin?

YMMV
25 January 2016 at 2:09 pm #10376
Price
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@price
How about neutrophils? They defend you against bacterial infections.

P.
25 January 2016 at 4:59 pm #10396
dointime
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@dointime
I just finished the ribavirin and the cetrizine. All my red blood cells are still within range, haemoglobin 11.8

White blood cells within range but borderline lymphocytes = 1.22
monocytes = 0.28 (lowest quartile)
Neutrophils = 3.26
Eosinophils – 0.13
Basophils = 0.11 – down from 0.16 pre tx
“All cell populations appear normal”

platelets = 241
MPV = 11

Everything else normal except for ALP = 29, which is low. Normal range = 35 – 104.
This value was lowish all year before tx, around 35, so I’m not concerned that the tx is the cause for it being low.

So long as the lymphocyte count is not a cause for immediate alarm I’ll be happy to just keep an eye on it until I am clear and recovered from all the meds. Hopefully it will normalise by then.

Your attention to this appreciated doc, and the others who took the time to help.
dt
31 January 2016 at 6:01 am #10848
Dr James
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@fixhepc
Hi DT,

That is a fine looking set of bloods.
- Red Cells / Haemoglobin carry oxygen.
- Neutrophils help fight bacterial infection
- Lymphocytes help fight viral infection
- Eosinophils go up in allergy states – to drugs, parasites (like worms), and in some people on the asthma/eczema spectrum
- Monocytes are a complex part of the immune system and do phagocytosis (garbage collection), antigen presentation and cytokine production. Elevated in glandular fever.
- Basophils tend to be irrelevant in clinical practice – heparin and histamine production
- Platelets are little plugs that seal up holes in your blood vessels and stop all the blood leaking out
ALP is a measure of liver outflow obstruction so high is a worry, low is fine.

The normal range for any value is the 95th percentile ie 95% of normal people have values within this range. A problem with the 95th percentile is that 5% of normal people have values outside that range, or to put it another way if I do 20 tests on a normal person it’s nearly a 100% chance that one value will be out of range (apologies to the statisticians – I do know it is technically 1 – 0.95^20 = 65.2% and never gets to 100%).

Good bloods. Be happy. I would be.

YMMV
31 January 2016 at 2:16 pm #10857
dointime
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@dointime
Hi doc James and thanks for this. It’s really great to get information like this.

I am doing my best to liberate myself from the ignorant state that my medical services would seem to want to keep me in. So I am indeed happy to know that my bloods are good and what they mean. I would go so far as to say that I can now dare to be optimistic about my outcome. You’d think that any caring doctor would want that for his patients, wouldn’t you, but somehow I always leave my hospital with feelings of fear and doom.

dt
31 January 2016 at 5:23 pm #10864
Geno1b4
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@geno1b4
”James-Freeman-facebook” wrote:
Hi DT,

That is a fine looking set of bloods.

Red Cells / Haemoglobin carry oxygen.

Neutrophils help fight bacterial infection

Lymphocytes help fight viral infection

Eosinophils go up in allergy states – to drugs, parasites (like worms), and in some people on the asthma/eczema spectrum

Monocytes are a complex part of the immune system and do phagocytosis (garbage collection), antigen presentation and cytokine production. Elevated in glandular fever.

Basophils tend to be irrelevant in clinical practice – heparin and histamine production

Platelets are little plugs that seal up holes in your blood vessels and stop all the blood leaking out

ALP is a measure of liver outflow obstruction so high is a worry, low is fine.

The normal range for any value is the 95th percentile ie 95% of normal people have values within this range. A problem with the 95th percentile is that 5% of normal people have values outside that range, or to put it another way if I do 20 tests on a normal person it’s nearly a 100% chance that one value will be out of range (apologies to the statisticians – I do know it is technically 1 – 0.95^20 = 65.2% and never gets to 100%).

Good bloods. Be happy. I would be.
Not meant to hijack the thread but reading this I remembered that last two blood works I had (6 months and 1 week ago) I had elevated Monocytes in %. Results are 8.2 and 10.4 respectively (normal range is 2.0 – 8.0%). Other stuff are normal except MCHC (g/L) slightly elevated 361 and 364 respectively (normal 320-360). Liver enzymes normal except slightly elevated AST (41) and ALT (59).
Could that be something else or is HCV related?

Genotype 1b & 4, F0/A1, failed Peg&Riba TX 2015,
22 Jan. 2016 – Back from Delhi with 12 week Ledifos supply 🙂 Thx to Parag
Started TX on 27.Jan.2016 – AST 41, ALT 59, GGT 39, ALP 74, VL 500.000, Fibroscan 6.8
19. Feb 2016 – ALT 14, AST 14, GGT 19, ALP 107
19. Apr 2016 EOT – Undetected 🙂
26. Apr 2016 (1 week after EOT) – ALT 14, AST 17, GGT 12, ALP 77
28. Aug 2016 (17 weeks after EOT) – UND, ALT 15, AST 12, GGT 5, ALP 39 🙂
2 February 2016 at 10:30 am #10983
Dr James
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@fixhepc
Could that be something else or is HCV related?

Really nothing to worry about. Have a look at SVR12.

YMMV
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