Blood work results causing issues?

[santa71]

I’m a 34 y/o male and I’ve been diagnosed with IBS for 5 years now for abdominal pain and bloating. I've improved over time due to increased fiber and finding food intolerances to onion and spicy foods. I would say I'm better and it's manageable now. I've seen a GI doc for a while and have ruled out all serious upper and lower GI problems. Over the years I've been more prone to fatigue and constant nasal congestion. My face complexion is usually red, bumpy and clammy. I always thought it was due to the IBS. I'm pretty active, work out regularly and I'm in good shape.  I’ve had blood work done for the last 2 years (once a year) and a few values always came in below/above normal.

Both times:
WBC 3900 per mm3 (low)
SEGS 46% (low)

Last year only:
AST/SGOT 72(high)
ALT/SGPT 99 (high)

The GI specialist ran more tests to check for HEP B,C, HIV and all came out NEG. He also ran an ANA screen which came out NEG. Thyroid tests also came in normal. All other standard blood work was normal.

Is there anything else I can explore with my PCP about the above info or do I chalk it up to food intolerance and rosacea. By the way, I have a severe allergy to shellfish and have to an EPI pen in case of an emergency.

Thanks,
Mark

[Kevin Pho, MD]

With the elevated liver enzyme tests, I would consider an abdominal ultrasound to image the liver and gallbladder.  Anatomical changes or masses can raise the liver function tests.  

The low WBC can be evaluated by a hematologist.  Various types of leukemia, infections, immune diseases, or medications can lower the WBC.  If the cause is non-revealing, a bone-marrow biopsy can be considered.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_b

[B_Johnson]

I agree with the above.  There are many causes for an increase in liver enzymes.  Some can be as simple as a heavy night of drinking the night before the test or starting a new medication like a statin.

Being that your LFTs were only increased last year and not with your most recent blood work, it is probably of little concern.

Your WBC count is low.  One concern is that the nasal congestion you are suffering from could be recurrent sinus infections... or it could just be allergies.

The segmented neutrophil count is less useful in a situation where you have a low overall WBC count.  In cases where WBC is elevated, increased segs signify active infection.  In this case however, it is hard to say exactly what it means.

I do not believe that there are any cutaneous manifestations of IBS.  The skin findings are most likely unrelated.

Followup bloodwork with a hematologist is a good idea.

[santa71]

Thanks for the info. I will be having a physical next week. I guess the results determine if I should see a hematologist.