Hello,
My teenage son had a blood test two years ago and came back the following
wbc 4.5 (4.5-13 range)
neutrophils 37 (40-65 range)
monocytes 17 (0-14 range)
absolute neutrophil 1665 (1800-8000 range)

just recently he had another test with the following:
wbc 3.6 (4.5-13 range)
Neutrophils 40.7 (53-61 range)
Monocytes 15.1 (4-12 range)
absolute neutrophils 1.4 (1.8-8 range)

These test were done by two different labs explaining their difference in normal ranges.

I am getting ready to speak to his pedi about this but was wondering what you all thought? All of the other readings were normal on the cbc's. He seems to come out low on the wbc and neutrophils and high on the monocytes. Is this something to worry about? Looking back over his past tests, he almost always came out on the low end of normal for wbc, going back years, unless fighiting a sore throat or illness. He was monitored for an enlaged lymph node years back but it ended up being a calcified reactive node and was not removed. Thank you for reading! His pedi was not concerned two years ago, but since this same result popped up again I am concerned.

Sarah,
Fluctuations in WBC counts happen like this depending on whats going on in his immune system at the time. If he had the same test later that day, the counts could be drastically different - maybe even normal.

Having said that, what you want to look for are trends. You are wise to get periodic counts so you can see what's going on over time. But at this time there's nothing standing out as a huge red flag.

Obviously, keep watch on him. Unexplained fevers or frequent illnesses are things to look out for or unusual fatigue. MAke sure they keep following him, but don't worry too much. And if you do get a future test with even lower WBC count, press to see a hematologist.

Jill

Hi Sarah

Your (sons) story sounds similar to mine. I was just diagnosed with Cyclic Neutropenia through the Mayo Clinic. It is a defect in the ELA2 gene and common in Swedish descendants. It took 8 years to get a diagnosis. I would get a 2nd opinion from a hematologist.
Back in 2000 was when they discovered my neutrophil count being low. A bone marrow biopsy was taken and did NOT reveal a reduction of white cells in marrow. By the time I got to the Mayo my blood somewhat normalized on the low end of normal and was told it was probably a virus.
About two years ago I discovered this problem never went away. About every 21 days my wbc goes down making me more prone to infections etc. I can tell when my blood is on a down cycle as it starts out with a sore throat, loose stools chills joint pain - knees and a low grade temp of 99 degrees.
My monocytes are low but I guess with age this condition worsens.
Interestingly enough I too have a calcified lymph node in my lung and blood test revealed reactive lymphocytes. Also my platelets are low but fluctuate.
I had another bone marrow and now shows a deficiency in production of white blood cells. Does you son feel sick a lot or low levels of energy?
I hope some of this helps - nothing is more frustrating than not knowing and drs writing you off.

ja - thank you for the insight. It makes me feel a bit better!
lowenergy - he doesn't feel sick or get tired too often. He has a good amount of energy most of the time. He gets the usual colds, sore throats, etc. but no more than anyone else.
I actually am in the process of communicating with his hematologist who saw him years ago with the lymph node issue and am waiting to see what he thinks. He has all of his records from before and is going to review them and get back to me. The pedi said this wasn't necessary but I really wanted to speak to this hematolgoist since he is a specialist. If he runs low and it's normal, I would just like a specialist to tell me that. Thanks for reading my post and giving your insight! I really appreciate it.