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  • Low reticulocyte and lymphocyte - need help

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    Old 09-07-2010, 08:29 AM   #1
    stilltired
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    Angry Low reticulocyte and lymphocyte - need help

    Thanks in advance...

    My medical history consists of Celiac Disease (november 2009) and a pacemaker for bradycardia/dysautonomia (oct 2008) caused by untreated Celiac nerve damage. I am also 24 years old and male.

    Over the last year, my WBC has always been between 4-6 (normal 4-11), absolute lymphocytes have been chronicaly low at 700-1200 (normal 1500-4000) and my RBC has been between 3.5-4.6 (normal 4.6 - 6.0).

    During fall 2009 my retic count was also checked and my absolute retic was at 14 (ref range 25-80). I was sent to a hematologist to get a bone marrow biopsy and one month before my appointment I was diagnosed with Celiac Disease. The hematologist retested my blood before the BMB and my RBC came back at 4.5 (normal 4.6 - 6.0) and my retic dropped to 13 (normal 25-80). She told me that the retic is not concerning enough to her for a BMB because my RBC is normal and she said Celiac may be the cause and sent me on my way.

    Since my Celiac diagnosis my RBC has stayed around 4.2 - 4.5 consistantly and my WBC has stayed around 4-6, with absolute lymphocytes still hanging low around 1000. I recently had another full checkup and here were my results:

    RBC: 4.4 (ref range 4.6 - 5.6)
    Hemoglobin (HGB): 135 (range 130 - 170)
    Hematocrit (HCT): 38.5 (range 39 - 50)
    PLT: 190 (range 140-400)

    ABS Retic: 15 (range 25 - 85)

    WBC: 5.76 (range 4.5 - 11)
    ABS Neutrophils: 4.19 (ref range 2.0 - 6.3)
    ABS Lymphocytes: 0.65 (ref range 1.5 - 3.5)
    ABS Monocytes: 0.57 (ref range 0.2 - 0.8)
    ABS Eosinophils: 0.31 (ref range 0.04 - 0.4)
    ABS Basophils: 0.03 (ref range 0.00 - 0.1)

    B12: 276 (range 220 - 1000)
    Ferritin: 71 (range 50-80=reduced, >80=normal)


    Also during my checkup I had a full body ultrasound to check for lymph nodes and some were found in my neck (largest 1.8cm x 0.8cm) and armpit (largest 2.5cm x 0.8cm). The lymph nodes were large, but appeared benign. The only worrisome looking lump was a small 8mm ill defined hypoechoic nodule was found on my thyroid and is being followed in 6 months intervals. My thyroid, vitamin and other panels were checked, which were all normal.

    Does anybody know why my retic would remain low, lymphocytes always low (now worse) with my RBC and WBC always remaining borderline low to low normal?

    My GP is confused at my results, but is unsure whether another trip to the hematologist is warranted or not. I feel like a BMB is needed even though I am not anemic. I feel run down all the time and I feel like the retic has a reference range for a reason. Any help is appreciated.

    Thanks.

     
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