HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

What Does The Following Blood Test Result Indicate?

Posted on Sat, 10 Jun 2017

Question: I am under investigation for suspected Coeliac's and just wondered if my blood test results are in line with that diagnosis or whether they are indicative of another problem. Haemoglobin 127; Red Cell Count 4.46; HCT. 0.4; MCV 88.6; MCH 28.5; MCHC 322; RDW 14.4; Platelets 221; MPV 11.6; White Cells 3.5; Neutrophils 1.53; Lymphocytes 1.43; 0.24 Monocytes; Eosinophils 0.29; Basophils 0.01
My Ferritin levels are 9.
I am 62 kgs, 5ft8 and have lost c.3.5kgs in the past 6 months without any changes to my diet.
Thanks

Answered by Dr. Shailja Puri (35 minutes later)

Brief Answer:
The blood reports are not diagnostic for celiac disease.

Detailed Answer:
Hello,
Thanks for posting your query on HealthcareMagic.
The blood report posted by you shows normal hemoglobin, hematocrit and red cell indices for your age.
The white cell count is mildly reduced.
Ferritin level is mildly reduced indicating an iron deficiency.
However, since hemoglobin is normal for age and sex, iron deficiency is in its initial stages.
I suggest you to get iron level also.
These tests are not diagnostic for celiac disease.
Celiac disease is diagnosed on the basis of clinical findings, raised tTgA levels and positive findings on biopsy taken from small intestine.
Celiac disease is one of the various causes for weight loss.
I suggest you to get tTGA to rule out / confirm celiac disease.

Thanks and take care
Dr Shailja Puri

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Shailja Puri (33 minutes later)

Thanks, I have had a colonoscopy and the results were: the duodenum looked normal but the biopsies have shown raised intra-epithelial lymphocytosis. I am booked in for a capsule endoscopy.

My Dexa scan shows mild spinal and femoral osteopaenia.

My Neutrophils and Lymphocytes have fallen from
5.65 Neutrophils / 2.16 Lymphocytes to 1.53 Neutrophils / 1.43 Lymphocytes since a previous blood test in 2011. Is this a cause for concern?

Answered by Dr. Shailja Puri (2 hours later)

Brief Answer:
Serum tTGA is required. Increased lymphocytes s/o celiac disease.

Detailed Answer:
Hello and welcome again,
The duodenal biopsy is showing increase in intra-epithelial lymphocytes.
This i suggestive but not path-gnomonic or diagnostic of celiac disease.
Additional serum tTGA is required.
Raised tTGA level above normal biological reference range will be diagnostic along with positive clinical features.
There is fall in neutrophils and lymphocyte count but this is due to overall fall in total leukocyte count.
I suggest you to take up serum tTGA levels.

Thanks and take care
Dr Shailja Puri

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Shailja Puri (25 hours later)

Yes I will get my serum tTGA levels checked but Coeliac investigations aside is the fall in leukocyte count a concern?

thanks

Answered by Dr. Shailja Puri (1 hour later)

Brief Answer:
You need to monitor white blood cell count monthly.

Detailed Answer:
Hello and welcome again,
The white blood cell count is not too low for deleterious effect, however, the level should be monitored monthly.

Thanks and take care
Dr Shailja Puri

Note: Do you have more questions on diagnosis or treatment of blood disorders? Ask An Expert/ Specialist Now

Above answer was peer-reviewed by : Dr. Prasad