Blood Test Results: What Your Numbers Really Mean

Q: Blood Test Results: What Your Numbers Really Mean

Dear Mr. <br>Hs：<br>1. <br>All examinations or tests, including Complete Blood Counts (CBC), must be interpreted in conjunction with clinical symptoms. <br>Clinical teaching focuses on critical thinking, utilizing clinical symptoms, chief complaints, physical examinations, labora

Blood test report examination?

Hello Dr.
Hsiao,
I am currently studying abroad, and my school recently required me to undergo a health check locally.
I visited the hospital last week and returned today to review my report.
My lab results show: Hb 16.0, Ht 45.6, RBC 5.20, WBC 4.43, Neutrophils 27.0 (reference 40-74%), Lymphocytes 56.0 (19-48), Monocytes 9.0, Eosinophils 5.0, Basophils 0.0, Atypical Lymphocytes 3, MCV 87.7, MCH 30.8, MCHC 35.1, Platelets 219, RDW-CV 11.8.

The neutrophils are too low, and the lymphocytes are too high, with a slight presence of atypical lymphocytes.
The blood was drawn around last Monday, but I had a bit of a cold around 4-5 PM, as I was feeling discomfort in my throat.
I took some medication I brought from a clinic in Taiwan, which improved my condition.
I am unsure if this has affected my blood cell abnormalities.

Six months ago in Taiwan, my blood test showed a total white blood cell count of 5.42 (normal range seems to be 4-10), with lymphocytes at 64, neutrophils at 26, and atypical lymphocytes at 4.
I also had a slight cold at that time.
After a week, I had another blood test, and my total white blood cell count was 4.42, with neutrophils at 33.7, lymphocytes at 57, and atypical lymphocytes no longer present.
My ESR was 13 mm/hr, and CRP was 0.023 mg/dL.
The doctor in Taiwan advised me not to worry too much, stating that the numbers were normal and not indicative of leukemia, which I feared was too serious.
Shortly after, I returned abroad to continue my studies.

However, this time the atypical lymphocytes have reappeared.
The local doctor mentioned that it likely isn't a concern and is probably related to the cold, advising me to monitor my symptoms and return if I feel unwell.
He also suggested that retesting after recovering from the cold would yield more accurate results, as these white blood cell variations are quite normal.
The data currently appears to show no significant issues, and I shouldn't worry.

I am now quite anxious about whether this could indicate a serious illness or leukemia.
I would like to ask for your perspective on these results.
I plan to return to Taiwan around the Lunar New Year, but I will need to undergo a 14-day home quarantine before I can visit a hospital.
Is the presence of atypical lymphocytes a bad sign? Also, could the abnormalities in those three parameters be related to my cold? The referral process here is somewhat complicated, and the local doctor does not see the need for further testing, so I can only consult you online for now.
I will wait until I return to Taiwan and am not sick to have my family doctor draw blood again.
Thank you for your response!

Hs, 20~29 year old female. Ask Date: 2020/11/09

Dr. Xiao Yongxun reply Family Medicine

Dear Mr.
Hs:
1.
All examinations or tests, including Complete Blood Counts (CBC), must be interpreted in conjunction with clinical symptoms.
Clinical teaching focuses on critical thinking, utilizing clinical symptoms, chief complaints, physical examinations, laboratory data, and imaging studies to arrive at possible diagnoses.
Based on your description, I believe that the interpretations and management by your physician in Taiwan or abroad are correct.
2.
Atypical lymphocytes can be present in cases of colds, viral infections, chronic diseases, and even in the blood of healthy individuals.
They may result from lymphocyte proliferation as the body responds to infections, leading to the appearance of transitional lymphocytes, known as atypical lymphocytes.
It is also possible that individual constitution may contribute to similar findings.
Therefore, these are normal responses of the hematolymphatic system and do not warrant excessive concern; often, a follow-up blood test after some time will show normal results.
3.
To my knowledge, no one has ever been diagnosed with leukemia or blood cancer solely based on a small number of atypical lymphocytes.
4.
If you have further questions, I recommend discussing them with your primary care physician, and try not to worry too much.

Reply Date: 2020/11/09

More Info

Understanding blood test results can be quite daunting, especially when you encounter numbers that seem out of the ordinary. In your case, you have provided a comprehensive set of blood test results, and I will help you interpret them, particularly focusing on the abnormalities you've mentioned: low neutrophils (Neut. Seg) and high lymphocytes (Lympho), along with the presence of atypical lymphocytes.

Key Blood Test Parameters:
1. Hemoglobin (Hb): Your level of 16.0 g/dL is within the normal range for adults, indicating that your red blood cells are adequately transporting oxygen.

2. Hematocrit (Ht): At 45.6%, this is also within normal limits, suggesting a healthy proportion of red blood cells in your blood.

3. Red Blood Cell Count (RBC): A count of 5.20 million cells/mcL is normal, indicating no issues with red blood cell production.

4. White Blood Cell Count (WBC): Your WBC count of 4.43 thousand cells/mcL is within the normal range (typically 4.0-10.0 thousand cells/mcL), indicating that your immune system is functioning properly.

5. Neutrophils (Neut. Seg): At 27.0%, this is below the normal reference range of 40-74%. Neutrophils are crucial for fighting off infections, particularly bacterial infections. A low neutrophil count (neutropenia) can occur due to various reasons, including viral infections, certain medications, or bone marrow issues.

6. Lymphocytes (Lympho): Your level of 56.0% is elevated compared to the normal range (19-48%). Lymphocytes are vital for the immune response, particularly in fighting viral infections. An increase in lymphocytes can often be a response to an infection.

7. Atypical Lymphocytes: The presence of atypical lymphocytes can indicate a viral infection or other immune responses. They are not necessarily indicative of a serious condition but warrant monitoring, especially if they persist.

8. Mean Corpuscular Volume (MCV): At 87.7 fL, this is within the normal range, indicating that your red blood cells are of normal size.

9. Mean Corpuscular Hemoglobin (MCH) and Mean Corpuscular Hemoglobin Concentration (MCHC): Both values are normal, suggesting that your red blood cells have adequate hemoglobin.

10. Platelet Count (PLt): Your count of 219 thousand cells/mcL is within normal limits, indicating proper clotting function.

Interpretation and Recommendations:
Given that you mentioned feeling under the weather around the time of your blood draw, it is quite plausible that your current symptoms and the resulting blood test abnormalities are related. Viral infections often lead to a decrease in neutrophils and an increase in lymphocytes, which aligns with your results.
The atypical lymphocytes you noted could be a response to the viral infection you experienced. It is common for these cells to appear during such times, and they typically resolve once the infection is cleared.
Your previous tests from Taiwan showed similar patterns, which further supports the idea that these fluctuations may be related to transient infections rather than a chronic condition like leukemia. The reassurance from your local doctor that these changes are likely benign is consistent with typical medical understanding.

Conclusion:
While it is understandable to feel anxious about these results, especially with the presence of atypical lymphocytes and the changes in your white blood cell differential, the context of your recent illness is crucial. It is advisable to wait until you are fully recovered from your current illness before repeating the blood tests, as this will provide a clearer picture of your baseline health.

If you continue to have concerns or if you experience new symptoms, it would be prudent to seek further evaluation. In the meantime, maintaining a healthy lifestyle, managing stress, and ensuring adequate rest can support your immune system as you recover. When you return to Taiwan, consider following up with your healthcare provider for another blood test to monitor your levels once you are well.

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