Low neutrophils, high lymphocytes

[Chery222]

My 13 year old son's absolute neutrophil count has been low for at least 10 months starting at 1.72 in November and now to 8.8.  HIs absolute lymphocyte count has been high ranging from 2.47 to 3.99 and now 2.64.  WBC have been normal until now it is a little low, 4,64.  He has fatique, headaches and paleness a lot.  This month his Monocytes were high, 14, for the first time.  Is this anything I should be concerned about?  The doctor said it was probably a virus but we have been dealing with him not feeling well for almost a year.  

[Mochadelicious]

I am so glad that he finally has a diagnosis (as I'm sure you are as well).  Not knowing is the hardest part, and now that you know what it is, you can focus on getting him better.  I've never heard of autoimmune neutropenia, but it just goes to show that there are so many blood diseases out there and trying to interpret blood labs and what they mean is nearly impossible for the untrained person.  

Can you please explain what autoimmune neutropenia is and what kind of treatments are required when blood levels require it?  This information may be helpful for others who may be experiencing similar symptoms.  Thanks Chery and I hope you continue to check in and keep us posted on your sons progress.

[Chery222]

Hi Everyone,
Sorry I did not reply right away.  My son had his bone marrow which came back clean.  They have diagnosed him with autoimmune neutropenia.  Possibly caused by a virus at some point.  They said that they will probably never know what is causing it and there are no other tests they feel are necessary.  They are just going to have his PCP monitor his bloodwork periodically.  I do feel confident that his hematologist ran every test they could at this point.  Right now we are just going to have his bood watched and hope he stays healthy.  Right now he feels pretty good most of the time but does start to feel lousy if he gets run down.  I hope are able to get a diagnosis soon.  It is soooo frustrating.  

[Ken_PA]

That would be "spleen", of course.

Also, I'd want to be sure that an actual person has looked at a slide of her blood - not that only a machine did it.

Also, when a person looks at her white blood cells, they can probably rule out leukemia.

If you get another CBC today, please post the results. You should get a copy immediately.

[Ken_PA]

Some viruses van keep nodes swollen for years, e.g. "chronic Epstein Barr"

I had noticed the elevated RBCs, I assume that if her RBCs are small (microcytic) and shaped wrongly (ovalocytosis), then her system makes more of them to keep up the supply of oxygen in her blood. (If a person goes to live at a high altitude where oxygen is low, then they make more RBCs.)

Is she getting enough iron in her diet?

I'll stress this which I'd posted earlier: "...some people may have crises in which the red blood cells rupture, especially if they have a viral infection."

In other words, if she has a condition of hereditary ovalocytosis, then a virus makes it worse.

Did you press on her speen? (below ribs on left side)

[janna77]

i forgot she has also a high RBC

[janna77]

we have just a family history of blood cancer in my mother side and my father side and liver cancer, and the swollen lymph nodes are in both sides of her neck, 2 in etch side and the 2 are close, about the deficiency of B12 and folic acid i dont think so, for how long do you think for a virus  to clear up? so we can have an other blood test and see whats gonna happen
and thank u so much for helping its really nice of you