Hi. If you're thinking of CML, your regular CBC would likely be showing elevated granulocytes (the counts of eosinophils, basophils and possibly neutrophils). But you don't mention that.
Rheumatoid arthritis can cause elevated immature granulocytes, because it's an inflammatory condition. I don't know if RA also can cause the aquagenic pruritus (itch from water). If it doesn't, here is a list of possible causes:
Do you happen to have a lot of allergies?
For your appointment, I would print out that page that I linked to. It's is from the official government NIH site, not just some random internet thing. I'd ask the doctor or NP about the part that says:
"-increased mast cell degranulation - release of granules rich in histamine and other compounds into the body by mast cells, a special type of cell that plays a role in the immune system
-increased circulating histamine"
You have multiple food sensitivities, which would involve mast cells . So all of your conditions are possibly linked. Unfortunately, though, mast cell diseases are not widely known in the medical community yet. So the person you talk to at your appt might not be aware.
Mast cells are powerful immune system cells. There is such a thing as reactive/inflammatory arthritis which is caused by immune reactions. You should take careful notice if food reactions lead to arthritis flares.
That is: THousands (of cells) per Cubic MilliMeter (of blood)
I would guess that an MPN disorder would show up in a CBC. Then again, it is there with the eosinophilia.
For mastocytosis, that won't show up on a CBC. Mast cells get born in the marrow and only circulate in the bloodstream very briefly until they take up their station in some tissue -- sort of on stationary guard duty against invaders. They coordinate and direct other immune cells.
A noted MC doc named Afrin says that he always does a double (bilateral, one in each hip bone) BMB, because there is a 1 in 7 chance of missing the mastocytosis cells in a single BMB.
They look for a 'KIT' mutation, which is kind of like a sensor on the surface of MCs that tells MCs to multiply too much.
The hema could have done a blood test for Tryptase. If that's strongly high for a while, that's a good sign that a BMB would show mastocytosis. But if it's normal, or only slightly high, there might still be mastocytosis. Still, your BMB(s) are a two for one approach so that seems good. It's not a big deal of a procedure, either. You can probably find youtubes of it being done.
My guess is that you have a MC disorder but not mastocytosis -- because you're not all that bad, relatively.
One thing you want to be on guard of is this: MCs can sort of summon eosinophils to an area, and it's the eosinophils that do the damage called 'remodeling'. Like making scar tissue. So be very aware of any problems such as swallowing food. Catch it early.
Good luck to you. Let me know how the BMB(s) go.
Mastocytosis refers to having way too many Mast Cells. But on the other hand, the majority of people with an MC disorder have a normal number of MCs, but they get set off too easily, releasing their array of powerful biochemicals when they shouldn't. Their MCs can release too many biochemicals, too easily, too often and sometimes for too long.
E.g., histamine is released from MCs and that explains the itching caused by water.
Do you have problems with finger joints at all? Or just large joints?
I really would try any generic BenGay ointment. It might sound too simple to work, but there's a good chance it will on finger joints. I'd look for menthol of 10%, some are lower.
Let me know the results, either way.
Here's the study recommending dual, bilateral BMBs for mastocytosis:
If you're not getting that, I'd ask the hema why, and show that paper.
Can you post the report, and any ranges?
On your profile, there's a place to upload photos. But you should black out any name etc
I'll be back tomorrow.
If the figures you're giving are from the biopsy (not from a CBC), there are no figures for blasts?
Those three you posted seem only slightly out or range. So your doc might not bother with advanced testing, such as looking for genetic mutations for PMN. That's my guess.
The biopsy would have shown mastocytosis if it were present, as they would have done the special staining for MCs.
Btw, for the record, it's not unusual for MCAS to cause eosinophilia as a downstream effect
Yep, that was very fast, though they conceivably could have done the 1st step on the biopsy sample which is looking with a microscope. I'd wondered if for some reason they'd rushed yours. That 1st part shouldn't take 2 weeks, though, unless there's something special in looking for PMN.
Advanced tests are often sent out to another place.
Well, those three relate to red blood cells (being small and/or immature) and this seems to point to something wrong in the marrow.
Have your got your bone marrow biopsy results? Is it something inconclusive?