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Crohn's Disease Forum » Parents of Kids with IBD » Help with blood test results


04-04-2014, 11:32 AM   #1
my little penguin
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Help with blood test results

April 2014
EOS 7% high ( 0-3)
Monocytes 13% high ( 3-9)
Lymph low 34%(35-65)
Ferritin 25.9(10-300)
Iron 43 low ( 45-182)
Abs monocytes 0.8 x 10E ( 0-0.8x10E)
Crp 0.1 ( 0.06-0.79)



Jan 2014
EOS 1%
Monocytes 6%
Lymphs 50%
Crp 0.03 DS is always below normal
Ferritin 9.7
Iron 75
Abs monocytes 0.5

Hgb and hct are normal .
He has been supplementing with Fe pills per Gi since Jan .


Any thoughts ?
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04-04-2014, 02:17 PM   #2
Patricia56
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Not a doctor but from what I've learned along the way...

Elevated eosinophils generally are associated with allergies of some kind. Are the abs values out of whack too?

Absolute monocytes are within normal range so something's a little bit off with the other numbers - probably the eosinphils and lymphocytes. I personally wouldn't be worried by what are relatively small variations in the % neutrophils. It's changes in the absolute values that I have learned to look for.

Great that the ferritin is getting better. Shows he's absorbing the iron supplementation. And again I wouldn't worry too much about the marginally low iron level. I would expect the iron to rise as the ferritin improves.

Great that the CRP continues low although it looks like that's not a great indicator for him. Nevertheless it's not going up which is good.

That's all I've got. Looks overall like he's doing OK. The WBC and RBC were normal?
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Nothing I say here should be construed as medical advice. I am not a doctor. These are just my opinions.
04-04-2014, 03:13 PM   #3
Jenn
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Great that the iron is going up! My son's eosinophils have been high too the last few months with allergies and asthma.
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Jennifer ~ son dx at age 8, Sep 2010
currently on Humira, Feb 2012+, MTX (15mg) Aug 2017+, folic acid
past use: 6mp for Sep 2010-Apr 2011 (not effective enough), then Remicade April 2011-Dec 2011 (built antibodies); additional 6MP Aug 2012-Sep 2013; Periactin for appetite Sep 2010-Sep 2013
other: Centrum chewable multi; calcium-vitD;
Derma-Smoothe for psoriasis rashes; Alrex, Zaditor eye drops for vernal conjunctivitis; history of asthma, ear infections
04-04-2014, 05:05 PM   #4
my little penguin
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So if his iron stores are increasing why is his iron level in the blood dropping?
The iron level wasn't dropping before and ferritin was only borderline low.
0.1 crp is actually very high for him.
Normal is undectable for him.
Sed rate is at 13 near his normal of 10.

Not concerned about EOS etc... He is a very allergic kiddo

Just confused on low Fe level
04-04-2014, 05:21 PM   #5
DustyKat
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I too would be thinking along the lines of allergy setting up an inflammatory response??

Being Spring there, has hayfever ever been an issue in the past?

Does he show any signs or symptoms of an underlying infection?

The low lymphocytes may be reflective of the immunosuppressive properties of the Humira.

Dusty. xxx
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04-04-2014, 05:25 PM   #6
DustyKat
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Perhaps the ferritin isnít a true reflection of what is going on. By that I mean, his iron stores may not be improving but his ferritin is rising in response to inflammation.

Dusty. xxx
04-04-2014, 05:30 PM   #7
my little penguin
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That was my concern Dusty .
He has severe allergies including spring pollens stuff .
Maxes out on allergy meds and gets allergy shots since age 4.
But he has had those since well before dx and none of his numbers for iron have been like this before ...
Guess I have to wait patiently for the GI to review ..
I don't wait well
04-04-2014, 05:50 PM   #8
DustyKat
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Waiting is the pits and I donít know that any of us are good at.

You would have to think that he is not absorbing his supplement. Do you think it is a possibility, given his long periods of inflammation, that he may have some scar tissue in his duodenum that is affecting the absorption of the iron?
That could be one explanation for the low iron despite being supplemented.

Or is the supplement the most suitable one?

Dusty. xxx
04-04-2014, 06:09 PM   #9
Patricia56
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While we have never seen a rise in ferritin in response to inflammation I have read that that can happen.

I do know that the way in which the body uses iron is very complex and there may be some other explanations as well. Waiting to see what the GI says is probably best.

Is he having symptoms that are worrying or are you looking for the canary in the coal mine i.e. the early warning signs of trouble?
04-05-2014, 12:33 AM   #10
Catherine
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Did the hemoglobin go up at all?

We have had rising ferritin in response to inflammation. They seem to be concerned if the ferritin level rises and the hemoglobin falls or remains the same.
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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)
04-05-2014, 02:26 AM   #11
kiny
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the lymphocyte counts look really normal to me, percentage is also different from an absolute count, which can also be measured

but some info about lymphocyte count maybe, I have ideopathic lymphonenia, it means low lymphocytes for an unknown reason, as a percentage they are often 10-15%, but since that doesn't mean much, often absolute CD4 / CD8 / CD48+ are measured, this is what I learned

lymphocyte counts differ if the blood is taken in the morning or evening

low lymphocyte counts in blood does not always mean low lymphocyte count in the body, it can but what is also possible is that the adaptive immune response recruited lymphocytes from the lymph system, so they are there..but they're in tissue

low lymphocytes does not mean all lymphocyte types are low, often it is either B or T cells, NK cells are rarely low, and it's very rare that both B and T cells are low, for me CD4 and CD8 are low, which are T cell differentiators, my NK and B cells are fine

if lymphocytes become really low, you are given preventive antibiotics and sometimes antivirals (I am given sulfamethoxazol so I don't get a lung infection, it's a prevention type antibiotics, even if I don't have an infection right now)

ideopathic lymphopenia differs from other diseases with low lymphocytes like HIV in that HIV they will keep dropping, with crohn's disease and ideopathic reasons, they remain stable usually, my T cells are quite low, but they don't drop...in ppl with HIV they keep dropping, which then results in infections etc

mood influences the immune system and especially lymphocytes, just being diagnosed with HIV often coincides with a further drop in lymphocytes, the psychological stress associated with diagnosis has a marked influence on the immune system

many ppl with crohn's disease have lower lymphocytes, it might just be because many of the T cells are present in tissue

Last edited by kiny; 04-05-2014 at 02:54 AM.
04-05-2014, 07:28 AM   #12
my little penguin
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Hgb-April
12.9

Hgb -Jan 2014
12.6

So basically no change at all.
His meds have not changed at all since June of last year either .
04-05-2014, 07:57 AM   #13
my little penguin
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http://m.australianprescriber.com/magazine/20/3/74/6

According to this if serum iron is going down but ferritin is going up and hgb is not increasing the inflammation is probably not helping the situation .
04-05-2014, 08:06 AM   #14
my little penguin
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​Trial of Oral Iron: If a patient is anemic due to iron deficiency repletion of iron stores should increase their hemoglobin. This forms the basis for the "trial of iron". Unfortunately no standards have been set for what constitutes an adequate trial. Most papers states that after one month of iron the hemoglobin should rise by 1-2 g/dl. Obviously patient compliance is key. Also fluctuation in any underlying inflammatory state will also affect the results. This test is of limited use but may be helpful in a select group of patients (e.g., young women with anemia).

From:
http://www.ohsu.edu/xd/health/servic...Deficiency.doc
04-05-2014, 09:21 AM   #15
Farmwife
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Thank you kiny. You answered some questions I've been wondering about.

Mlp our kids are alike. Low wbc's and low ferritin but other labs are fine. Her doctors are not concerned.

However my girl with egid's plus an asthma flare as we speak and allergies running a muck has no raised eos in labs. Go figure.
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04-05-2014, 01:20 PM   #16
Maya142
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We have had very high ferritin due to inflammation - for the last year now (much higher than 300 can't remember the exact number). M is supposed to be in remission now so I'll be interested to see what her next ferritin is.
She did have to iron infusions once when it was low. She just didn't tolerate/absorb iron supplements.
Her iron issues at that time (low-normal hemoglobin, very low ferritin) confused her pediatrician and rheumatologist so much that she was sent to a pediatric hematologist.
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Mom of M (20)
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Juvenile Ankylosing Spondylitis at 16

Mom of S (23)
dx with JIA at 14
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04-05-2014, 09:28 PM   #17
kimmidwife
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What iron supplement are you using? He may not be absorbing it especially if he has inflammation. I would speak with the doctor about another supplement possibly.
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04-05-2014, 09:51 PM   #18
my little penguin
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Kim
We are using a chelated iron which is suppose to be easier to absorb.
We see the Gi soon so I will discuss what the number mean then and if we should change anything.

I would have thought the hemoglobin would have went up and the serum iron would not have gone down .
DS is acting ok so just off numbers at this point .
04-06-2014, 05:07 AM   #19
Catherine
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The hemoglobin has gone up but not much.

Our GI says the serum iron level is unreliable as it varies between times of day.
We have never had it range.

http://www.perthhaematology.com.au/axiron.htm
04-10-2014, 06:24 PM   #20
Jenn
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We had a problem with stubbornly low protein on Humira only and added 6mp which corrected it. Only did 6mp for a year, then went to the adult dose of Humira and doing ok so far on that alone. Hope it's not that way for you, just throwing it out there.
04-10-2014, 08:33 PM   #21
my little penguin
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Thanks Jenn
DS has been on the adult dose of humira since last June.
He weighs at least eighty pounds .
6-mp goes to his liver and Mtx gave him vasculitis possibly ...
He likes to be difficult.
But still need to wait for the Gi appt to see what if anything is a concern .
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