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Crohn's Disease Forum » Tests for IBD » Blood Tests » Help with Blood test results


01-20-2013, 01:03 PM   #1
Jmrogers4
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Help with Blood test results

Latest Blood Test - normal range in parenthesis
WBC count 2.6 (4.5-13.5 K/UL)
RBC Count 3.71 (4-5.3 MIL/UL)
Hemoglobin 12.1 (12-15 G/DL)
Hematocrit 34.9 (37-46 %)
Neutrophil % 37 (40-76)
Lymphocyte % 57 (25-48)
ESR 10 (0-15)
CRP <0.5 (<1)
You all are so good I've just always taken the GI's word that says they look good. Can you help me decipher? There are more numbers and such on there, what should I be looking at?
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Jacqui

Mom to Jack (18) dx Crohn's 2/2010
Vitamin D -2000mg
Remicade - started 1/9/14; 7.5ml/kg every 6 weeks
Centrum for Him teen multivitamin
Past meds: Imuran/Azathioprine; allopurinol; methotrexate; LDN; Prednisone; Apriso; Pentasa; EEN

Husband dx Crohn's 3/1993
currently none due to liver issues
01-20-2013, 01:26 PM   #2
itsme2
 
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xx

Last edited by itsme2; 05-05-2013 at 03:26 PM.
01-20-2013, 01:38 PM   #3
Jmrogers4
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Yes could be anemic has taken iron pills in the past he would forget to take them a lot of the time and GI said that was fine he didn't need to take them anymore. He didn't say anything about starting them up again though.
01-20-2013, 01:56 PM   #4
itsme2
 
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Last edited by itsme2; 05-05-2013 at 03:18 PM.
01-20-2013, 01:57 PM   #5
Jmrogers4
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June, seems a long time guess I will give him a call and ask if we should start up iron pills again
01-20-2013, 02:07 PM   #6
Trysha
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Total WBC and RBC low.
The differential is a bit off, the lymphocytes have an increase over the neutrophils.
Could be indicative of a recent virus infection or maybe a drug reaction..
You certainly should be speaking to the GI soon to find his/her thoughts about this blood picture., and what it all means for you.
Feel better soon
Hugs and best wishes
Trysha
01-21-2013, 02:42 AM   #7
Catherine
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The hemoglobin is on the low end of normal range. I would have iron studies done before giving. B12 and folate also play a roll in hemoglobin levels.
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Catherine
Mother of Sarah dx aged 16, Jan 2012
DX - CD 1/12, asthma
Small bowel to small bowel fistula

Meds: ), azathioprine 200mg, Mesalazine 1.2g x 2, seretide 250 x 2 (asthma), ventolin (as needed)

Currently no supplements.

Has previously taken Multi B, Caltrate, B12 & Iron

Prednisolone (from 30 mg 01/02/2012 to 17/06/2012, 30mg 24/10/12-28/12/12, 50mg 24/1/13-27/4/13)
01-29-2013, 06:46 PM   #8
Patricia56
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#1 thing - you need to talk to your doctor about this or his NP. Tell them you would like them to explain the results not just tell you they are "fine". Please review any information I provide with your doctor who has spent many years studying hard to learn what this stuff really means in terms of your child's overall health and well being.

All that said, when you decide to post lab ressults you need to post more informatoin than this.
you need to post the absolute values and % values for all the neutrophils. Also the platelet count (poor man's ESR), RDW, MCV, etc. are very helpful in understanding what's going on. There's a reason they run all of those tests together. They inter-relate and the interpretation can change dramatically basedon those relationships.

Remember that a blood test is a snapshot and normally should be used to inform the clinical picture as a whole. abnormal values generally should result in a repeat test to check the result after a short period of time - week to month for exammple.

Latest Blood Test - normal range in parenthesis

WBC count 2.6 (4.5-13.5 K/UL) - low total number bears watching; if it continues to be low then may need further investigation to r/o causes; LDN is supposed to stimulate the immune system causing increases in WBC so this result is counter to that expected (as I understand it not being a doctor)

RBC Count 3.71 (4-5.3 MIL/UL)this result is probably within the margin of error for this test however the low H&H suggest it is a valid number. It would be helpful to know the results of the RDW and MCV which might help shed light on the results.

Hemoglobin 12.1 (12-15 G/DL) within limits, are you doing any iron supplementation?

Hematocrit 34.9 (37-46 %) obviously low, did he drink a bunch of fluids before the blood draw?

The next two are types of WBC's and knowing the % is only somewhat helpful. For example it may seem fine that he has a neutrophil count only slighly below normal range but if the total absolute number is tiny then that's not good right? Knowing the distribution of all the types of WBC's on the report is important in CD. Monocytes are one of the main types of WBC's that we want to see stay in the normal range. % distribution can be knocked out of kilter by high eosinophils which are triggered by allergies. Etc. you get the picture.


Neutrophil % 37 (40-76) Hard to say much without more information

Lymphocyte % 57 (25-48) same here although the elevated % does seem to match with the LDN activating the immune system. The only problem is that the overall WBC is so low.

ESR 10 (0-15) - looks good; a very gerneralized measure of inflammation
CRP <0.5 (<1) - also looks good; a more time-limited general measure of inflammation
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Badger, 18, CD, overall great guy
Dxd age 10, 2006 after nearly 1 year of active sx
Current CD meds: Remicade, Methotrexate and Omeprazole, Vit. D, Calcium, Folic Acid, Probiotic

Nothing I say here should be construed as medical advice. I am not a doctor. These are just my opinions.
01-29-2013, 07:08 PM   #9
Johnnysmom
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We just got back from the GI today and he told us that all of the labs should be in the normal range except for the Neutrophil %, Lymphocyte % and Mono absolute.

But he said the Neutrophil should be higher than normal range and Lymphocyte should be lower than normal range. There is apparently a push and pull with these two tests when one goes up the other goes down to compensate and visa versa. He did say that these should be off because Johnny was on immune suppressants and that was what causes them to be off, so I am sure with LDN that would change things.

The WBC is what would concern me. When Johnny was at 3.0 the Dr. changed his meds and was concerned with this low of a level. Johnny's is currently at a 9.0 which the Dr. was very happy with. 2.6 seems very low, but Patricia knows more about this than I do so perhaps it is not as concerning as I thought it might be. But those numbers along with how thin Jack is would really concern me.

(((((Hugs))))))
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Dx Oct 11 2011 Crohns disease
Prednisone done 12/30/11
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Allopurinol 50mg -discontinued per new G.I. on 11/01/12
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01-29-2013, 08:59 PM   #10
Jmrogers4
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MCV 94.1 (75.0-95.0) FL
MCH 32.6 (23.0-34.0) PG
MCHC 34.7 (31.0-37.0) %
RDW-CV 14.8 (11.0-16) FL
Platlet count 197 (150-420) K/UL
MPV 7.1 (7-10) FL
Monocyte % 3 (1.0-10.0)
Eosinophil % 2 (0.0-3.0)
Basophil % 1 (0.0-1.0)
Neutrophil # 0.96 (1.80-10.10) K/UL
Lymphocyte # 1.50 (1.2-6.40) K/UL
Monocyte # 0.08 (0.10-0.70) K/UL
Eosinophil # 0.06 (0.00-0.50) K/UL
Basophil # 0.02 (0.00-0.10) K/UL
01-31-2013, 01:27 AM   #11
Patricia56
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WBC count 2.6 (4.5-13.5 K/UL)
RBC Count 3.71 (4-5.3 MIL/UL)
Hemoglobin 12.1 (12-15 G/DL)
Hematocrit 34.9 (37-46 %)
Platlet count 197 (150-420) K/UL

MCV 94.1 (75.0-95.0) FL
MCH 32.6 (23.0-34.0) PG
MCHC 34.7 (31.0-37.0) %
RDW-CV 14.8 (11.0-16) FL
MPV 7.1 (7-10) FL

Neutrophil % 37 (40-76)
Lymphocyte % 57 (25-48)
Monocyte % 3 (1.0-10.0)
Eosinophil % 2 (0.0-3.0)
Basophil % 1 (0.0-1.0)

Neutrophil # 0.96 (1.80-10.10) K/UL
Lymphocyte # 1.50 (1.2-6.40) K/UL
Monocyte # 0.08 (0.10-0.70) K/UL
Eosinophil # 0.06 (0.00-0.50) K/UL
Basophil # 0.02 (0.00-0.10) K/UL

ESR 10 (0-15)
CRP <0.5 (<1)

Please remember that this is my laymom interpretation of this information based on what I've been told or learned over the years. I'm sure that a doctor would have a much m ore sophisticated interpretation/understanding of this information than I do.

The low WBC is reflected in the low absolute levels of Neurtophils and Monocytes. Even the Lymphocyte count is close to the low end. You can see how knowing the absolute numbers influences your interpretation of the %. The lymphocyte % looks really high but the actual amount of lymphocytes is in the normal range - even on the low end of the range. The % is high not because there are a lot more lymphocytes but because there are fewer monocytes and neutrophils. And the neutrophils that were only a little low at 37% look a lot lower when you see the normal range starts at 1.8 and the absolute number was 0.96.

If LDN is supposed to be stimulating the immune system it doesn't appear to be showing up in these labs. I don't know if you have a copy of his labs from before he started LDN but it's always best to look at labs over time. The numbers might have been the same then you know?

I agree that that low a WBC is worrying. I would call and ask the doctor's office about it since it is clearly supported by the other lab values (low neutrophils especially) and both the RBC and the hematocrit are below normal levels. I would want them to follow up with repeat labs within a 7 to 14 days to make sure the WBC in particular came up. If not then there needs to be sone investigation into why it's so low. And in the meantime I would take some extra caution exposing him to germs if you can. Stay home from parties or big gatherings, hand washing ,etc.

The normal platelet count is good and goes with the ESR and CrP being in the normal range. Those are all inflammatory markers.

The RBC is only a little low but the hematocrit is definitely low. Hematocrit is a measure of the volume of RBC's in the blood. If he had a lot to drink right before the lab draw (a LOT) that might have caused this resul.)

RDW is a measure of the variation in size of the RBC's and MCV is a measure of the size of the RBC's. As I understand it there are some tentative conclusions you might be able to draw from those values.

The MCV is at the high end so I would interpret that as meaning that the RBC's are mature, normal size and shape. The RDW is right in the middle of the normal range so there 's no unusual variation in the size or shape of the RBCs. For example, in some kinds of anemia you might see a high RDW because there are a lot of new immature RBC's being released to compensate for the early death of normal, mature RBC's. That doesn't seem to be happening here.

MCHC is a measure of the amount of hemoglobin in packed RBC's. In anemia you would expect it to be low but it's not here. And the MPV is a measure of platelet volume. It's within normal range but on the very low end.

Did it say that the peripheral smear was normal?

I do think you need to talk this over with someone at the doc's office. Maybe get them to order a new set of labs to see if this was just a fluke. Focus on your concern over the very low WBC and don't worry about all this other stuff. The main thing that needs to be checked out (as far as I know) is that he is producing WBC's at a normal rate and there's nothing wrong with the WBC production or something causing early death of the WBC's.

Last edited by Patricia56; 01-31-2013 at 01:52 AM.
01-31-2013, 10:57 AM   #12
Jmrogers4
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Well we are going in for scopes and bloodwork on Tuesday, as this test was quite a while ago more at the start of LDN and things are just not progressing - no pain, BM's are fine but weight and growth are almost non-existent and he is extremely fatigued. Went to the GI's yesterday and first thing doctor says to him is you look pale, how are you feeling. He suspects inflammation in small intestine.
01-31-2013, 11:55 AM   #13
oscar
 
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ask your doctor about azathioprine,in most patients who take this drug its ok
and only get mild side effects.
but for some like me it could lead to leucopaenia ( reduce white blood cell count)
im still on the drug and it keeps me fine most of the time with the odd flare up now and again.
my gp keeps a very close eye on my blood tests.
01-31-2013, 12:01 PM   #14
Jmrogers4
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Thanks Oscar he was on azathioprine before switching to LDN, he tolerated it well just couldn't seem to get the job all the way done. He can't do methotrexate due to a reaction so we are left with some tough decisions once we see what scopes show
01-31-2013, 02:22 PM   #15
oscar
 
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hi jmrogers, azathiopine works by killing new white blood cells to stop your immune system from attacking you.
white cell count should be between 4.0 and 10.0 to stop infections
below 3.2 alarm bells start ringing.
mine went down to 2.9 that is how i know,taken off azathioprine went up to normal levels.
given lower dosage this happened twice started on 175 now on 125mg but i am an adult and not a child.
i hope this is of some use to you
01-31-2013, 04:11 PM   #16
xmdmom
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When was this blood test done? Did he have a repeat cbc since these results? If he didn't have a repeat, I think getting one prior to the scope could be a good idea to make sure WBC is up, as you wouldn't want to scope with a really low WBC. Common causes of low WBC are viruses and drug reactions. Had he been on other meds recently, when he got this blood test?

Sorry he isn't feeling well and that he needs endoscopy again.
01-31-2013, 05:05 PM   #17
Jmrogers4
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They are doing blood again day of scopes GI said do it all at once. I'll check in with GI. Thanks xmdmom for the heads up
02-06-2013, 10:10 PM   #18
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Results from yesterdays blood tests: normal in paranthesis. Looks good, yes?
WBC 5.4 (4.5-13.5 K/UL)
RBC 5.22 (4.0-5.3 MIL/UL)
Hemoglobin 14.4 (12.0 - 15.0 G/DL)
Hematocrit 41.9 (37.0-46.0 %)
MCV 80.3 (75.0-95.0 FL)
MCH 27.6 (23.0-34.0 PG)
MCHC 34.4 (31.0 - 37.0 %)
RDW-CV 12.2 (11.0-16.0 FL)
Platelet Count 224 (150-420 K/UL)
MPV 7.9 (7-10 FL)
Neutrophil % 48 (40-76 %)
Lymphocyte % 44 (25-48%)
Monocyte 6 (1-10.0 %)
Eosinophil % 1 (0.0-3.0 %)
Basophil % 1 (.0-1.0 %)
Neutrophil # 2.59 (1.80-10.10 K/UL)
Lymphocyte # 2.36 (1.20-6.40 K/UL)
Monocyte # 0.31 (.10-0.70 K/UL)
Eosinophil # 0.07 (0.00-0.50 K/UL)
Basophil # 0.02 (0.00-0.10 K/UL)
C-Reactive Protein <0.5 (<1 MG/DL)
ESR 7 (0-15 MM/HR)
02-06-2013, 10:33 PM   #19
Patricia56
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Looking good to me. What'd the doc say?
02-06-2013, 10:37 PM   #20
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He thought they looked good as well and we were expecting poor results due to weight loss "failure to thrive"
02-06-2013, 10:51 PM   #21
xmdmom
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Curious if they checked total protein or albumin to assess nutritional status?

I'm jealous of that creactive protein!
02-06-2013, 11:06 PM   #22
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I'm jealous of that creactive protein!


Total Protein 7.4 (6.4-8.6 GM/DL)
Albumin 4.7 (3.8-5.6 GM/DL)
02-06-2013, 11:15 PM   #23
xmdmom
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Wow! It all looks so good! Hope he will gain weight on the drinks so he can match his labs!
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