Aa
Quik If you have the Time Thanks
I got LP results the only question is on one it states Rare Benign Mononuclear Cells--No Malignant Cells Identified
CSF
Color-Colorless
Charactor-Clear
Clot-No Clot
Blood-Negative
WBC 0
RBC 0
Total Protein 43 Scale 15-45
Glucose 54 40-70
Lyme Negative
VDRL Negative
CSF Bands 3
Serum Bands 2
CSF Olig Bands Interpretation 1 Scale <4
CSF Cryptococcal Antigen Negative
Stain, Gram (sterile source)
Cytospin slide shows: Rare white blood cells
No bacteria seen
Culture CSF
No growth in 4 days
Nuero nurse advise all Good--any thoughts--History in past post Thanks
P.S. Primary advised Mononuclear is from EBV--Do you agree?
CSF
Color-Colorless
Charactor-Clear
Clot-No Clot
Blood-Negative
WBC 0
RBC 0
Total Protein 43 Scale 15-45
Glucose 54 40-70
Lyme Negative
VDRL Negative
CSF Bands 3
Serum Bands 2
CSF Olig Bands Interpretation 1 Scale <4
CSF Cryptococcal Antigen Negative
Stain, Gram (sterile source)
Cytospin slide shows: Rare white blood cells
No bacteria seen
Culture CSF
No growth in 4 days
Nuero nurse advise all Good--any thoughts--History in past post Thanks
P.S. Primary advised Mononuclear is from EBV--Do you agree?
Other than the one O-Band I see no problems. As I said, the O-Band does indicate some immune inflammation "at some time" and a certain (small) number of healthy people will have one. But, it should be kept in mind along with all the other info. It is a "negative" result, but not necessarily a "normal" one.
Q
Q
Well, I'm sorry for the lapse.
This is the part about getting your own lab results that is potentially detrimental. We worry unnecessarily about things flagged as high or low by a computer program. It's important to know that some person entered the "high" and "low" values for each test based on where the healthy population "fits" for those tests. The high/low values represent either the 90th %ile or the 95th %ile and the 10th or 5th %iles. That means that either 90 or 80 percent of the poulation will fall within the normal range. Of course, this means that 10 or 20 percent will fall outside it and still be normal.
Also, it is the rare lab test where a result that is "barely" outside the norm, means anything dire. If a liver test is normal from 10 to 45, then a result of 51 means very little.
In your case, the percentage of monocytes in particular is rarely of any interest to the docs unless it it is very high and then they start a search for leukemia. A result of 12% with the reported high of 11% really does mean nothing.
Finally you have to realize that there is some margin of error in all lab testing, so a result that is barely high or low, is likely still with what is called "the margin of error" for that test. I agree with your docs that 12% of monocytes on a CBC wouldn't even make me blink.
Quix (sorry you had to wait for this)
ps - funny story. Where I worked in Chicago our lab posted the normal range of "lead" in the blood as 4 - 10. Now, whomever programmed this was working off a list that reported what the normal range was that they had actually "found" in people. In reality, the "normal" amount of lead is ZERO. When a child's lab came back with a result of 3, the parents got all worried. So, we were diagnosing "lead deficiency!" The docs are trained to interpret the "highs" and "lows" of most lab results. Flagging the results of High and Low makes it easy to home in on the possible abnormals, but it can cause a lot of unnecessary worry.
This is the part about getting your own lab results that is potentially detrimental. We worry unnecessarily about things flagged as high or low by a computer program. It's important to know that some person entered the "high" and "low" values for each test based on where the healthy population "fits" for those tests. The high/low values represent either the 90th %ile or the 95th %ile and the 10th or 5th %iles. That means that either 90 or 80 percent of the poulation will fall within the normal range. Of course, this means that 10 or 20 percent will fall outside it and still be normal.
Also, it is the rare lab test where a result that is "barely" outside the norm, means anything dire. If a liver test is normal from 10 to 45, then a result of 51 means very little.
In your case, the percentage of monocytes in particular is rarely of any interest to the docs unless it it is very high and then they start a search for leukemia. A result of 12% with the reported high of 11% really does mean nothing.
Finally you have to realize that there is some margin of error in all lab testing, so a result that is barely high or low, is likely still with what is called "the margin of error" for that test. I agree with your docs that 12% of monocytes on a CBC wouldn't even make me blink.
Quix (sorry you had to wait for this)
ps - funny story. Where I worked in Chicago our lab posted the normal range of "lead" in the blood as 4 - 10. Now, whomever programmed this was working off a list that reported what the normal range was that they had actually "found" in people. In reality, the "normal" amount of lead is ZERO. When a child's lab came back with a result of 3, the parents got all worried. So, we were diagnosing "lead deficiency!" The docs are trained to interpret the "highs" and "lows" of most lab results. Flagging the results of High and Low makes it easy to home in on the possible abnormals, but it can cause a lot of unnecessary worry.
P.S.
My last CBC(May09) revealed my monocytes were 12% on a scale of 1-11% this was also of no concern to my docs
My last CBC(May09) revealed my monocytes were 12% on a scale of 1-11% this was also of no concern to my docs
Thanks so much--you are great--a few answers to your questions
The test was sent to the Mayo clinic in New York for testing--the following is a few results I left off--also
myelin basic protein, csf 0.6 Scale <1.5
(CSF) IgG Index 0.56 <=0.85
IgG, CSF 3.28 <=8.1
Albumin, CSF 20.70 <=27.0
IgG/Albumin,CSF 0.16 <=0.21
Synthesis Rate, CSF 1.59 <=12
IgG, S 1090 600-1500
Albumin, S 3820 3200-4800
IgG/Albumin, S 0.3 <=0.4
All within Range--any further thought would be greatful Padro
The test was sent to the Mayo clinic in New York for testing--the following is a few results I left off--also
myelin basic protein, csf 0.6 Scale <1.5
(CSF) IgG Index 0.56 <=0.85
IgG, CSF 3.28 <=8.1
Albumin, CSF 20.70 <=27.0
IgG/Albumin,CSF 0.16 <=0.21
Synthesis Rate, CSF 1.59 <=12
IgG, S 1090 600-1500
Albumin, S 3820 3200-4800
IgG/Albumin, S 0.3 <=0.4
All within Range--any further thought would be greatful Padro
Sorry I took so long.
The first thing you need to understand is that white cells can migrate to wherever they are needed all over the body. These are the White Blood Cells of the blood, WBC's. There are 5 main kinds. The two major ones are the Neutrophils which are the first attackers in most any infection, but especially bacterial ones. Pus is made up of 99% dead neutrophils. The second main WBC are the Lymphocytes and they respond mainly to inflammation from viruses, TB and other non-infectious causes of inflammation. The next category are the Monocytes which are the demolition and repair cells of tissue damage. They gobble up debris and help with healing. Then there are Eosinophils which are the culprits in allergies. Finally, there are basophils, and, to be honest, I really don't know what they do, lol. (yes, I could look it up, but I'm short of energy. :(()
At any given time you can find any of these cells occasionally in all parts of the body. Finding a rare one of them in the spinal fluid is not a sinister thing - it is not alarming at all. Now why did they mention it? Because they were looking at the entire cell population in the CSF. One of the things that can cause neurological problems is a cancer or spread-over of leukemia in the Central Nervous System, so every diagnostic LP sends some fluid to the lab for "cytology." "Cyto" means cells. "Cytology means "the study of cells."
Why does one test say 'No WBC's" and another reports the rare, normal monocyte? This is because the cytology lab actually works to concentrate any cells that are there so they catch much more than just looking at the CSF unconcentrated to see how many cells (RBS's and WBC's) are in the microdrop on the slide under the microscope.
When they found a rare monocyte in your CSF it was appropriate for them to specify whether it looked like a form of monocytic leukemia or whether it looked like any old monocyte that had wandered into the CSF. So they reported that it looked benign, as opposed to looking malignant. This is a very good thing.
Why was it there in the first place? Because sometimes they are there. It happens. Was it due to EBV? Possibly if you have had an acute bout of EBV infection recently. However, typically what EBV does is cause "atypical lymphocyte" formation and not a monocyte stimulation. But, it really does not matter. Some monocytes found their way into the CSF: they do not have malignant changes in their appearance and we don't need to think about it further.
Remember the monocytes found were "rare." They cause no harm and are a very weak indicator of some inflammation, possibly in the past. Put any worry about them aside. It is clear that you have had some source of inflammation because of the O-Band. Yes, there is only one, but it is still not normal. Having only one doesn't count for much because a small number of healthy people also have one, possibly from a past infection.
When my MS neuro diagnosed me with 90% confidence that it was MS, I only had 1 O-Band also. He said he would rather I had 2 or more, but one was still a weak indicator pointing to MS.
I see that the lab for your report states the abnormal number of O-Bands as "4 or more." Can you tell which lab ran that test? This is a push by the Mayo Clinic to change the number of O-Bands which are a positive result for MS from "2 or more" to "4 or more." I believe this is part of their push to make MS harder to "qualify for." It seems to be a political attitude on the Mayo's part to reduce the number of people being diagnosed, since they had to eat their words about withholding DMDs for "benign" MS.
I didn't see the other test that is considered a potential indicator towards MS. That is the one called the IgG Index. Was that run on your fluid? I don't know what the Mayo Clinic's attitude is toward the IgG Index, but I would predict that they feel it not sensitive enough and there are too many false positives. The rest of the neurological field is still using the Index and it is part of the "supporting evidence" of the McDonald Criteria.
Does any of this help?
Quix
The first thing you need to understand is that white cells can migrate to wherever they are needed all over the body. These are the White Blood Cells of the blood, WBC's. There are 5 main kinds. The two major ones are the Neutrophils which are the first attackers in most any infection, but especially bacterial ones. Pus is made up of 99% dead neutrophils. The second main WBC are the Lymphocytes and they respond mainly to inflammation from viruses, TB and other non-infectious causes of inflammation. The next category are the Monocytes which are the demolition and repair cells of tissue damage. They gobble up debris and help with healing. Then there are Eosinophils which are the culprits in allergies. Finally, there are basophils, and, to be honest, I really don't know what they do, lol. (yes, I could look it up, but I'm short of energy. :(()
At any given time you can find any of these cells occasionally in all parts of the body. Finding a rare one of them in the spinal fluid is not a sinister thing - it is not alarming at all. Now why did they mention it? Because they were looking at the entire cell population in the CSF. One of the things that can cause neurological problems is a cancer or spread-over of leukemia in the Central Nervous System, so every diagnostic LP sends some fluid to the lab for "cytology." "Cyto" means cells. "Cytology means "the study of cells."
Why does one test say 'No WBC's" and another reports the rare, normal monocyte? This is because the cytology lab actually works to concentrate any cells that are there so they catch much more than just looking at the CSF unconcentrated to see how many cells (RBS's and WBC's) are in the microdrop on the slide under the microscope.
When they found a rare monocyte in your CSF it was appropriate for them to specify whether it looked like a form of monocytic leukemia or whether it looked like any old monocyte that had wandered into the CSF. So they reported that it looked benign, as opposed to looking malignant. This is a very good thing.
Why was it there in the first place? Because sometimes they are there. It happens. Was it due to EBV? Possibly if you have had an acute bout of EBV infection recently. However, typically what EBV does is cause "atypical lymphocyte" formation and not a monocyte stimulation. But, it really does not matter. Some monocytes found their way into the CSF: they do not have malignant changes in their appearance and we don't need to think about it further.
Remember the monocytes found were "rare." They cause no harm and are a very weak indicator of some inflammation, possibly in the past. Put any worry about them aside. It is clear that you have had some source of inflammation because of the O-Band. Yes, there is only one, but it is still not normal. Having only one doesn't count for much because a small number of healthy people also have one, possibly from a past infection.
When my MS neuro diagnosed me with 90% confidence that it was MS, I only had 1 O-Band also. He said he would rather I had 2 or more, but one was still a weak indicator pointing to MS.
I see that the lab for your report states the abnormal number of O-Bands as "4 or more." Can you tell which lab ran that test? This is a push by the Mayo Clinic to change the number of O-Bands which are a positive result for MS from "2 or more" to "4 or more." I believe this is part of their push to make MS harder to "qualify for." It seems to be a political attitude on the Mayo's part to reduce the number of people being diagnosed, since they had to eat their words about withholding DMDs for "benign" MS.
I didn't see the other test that is considered a potential indicator towards MS. That is the one called the IgG Index. Was that run on your fluid? I don't know what the Mayo Clinic's attitude is toward the IgG Index, but I would predict that they feel it not sensitive enough and there are too many false positives. The rest of the neurological field is still using the Index and it is part of the "supporting evidence" of the McDonald Criteria.
Does any of this help?
Quix
Thanks Jen--Thats what the Nueros nurse said as well yesterday--and there was nothing I could do for it but time---Well its been a year and a half now does it EVER go away?
I'm not quix, but almost certainly the white blood cells (mononuclear) are from the viral infection in the spine.
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