Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Ear Doctor, I Hope You Are Doing Well. I Have
Question: ear Doctor, I hope you are doing well. I have had a total thyroidectomy (TT) 2 years ago and on my pathology report of thyroid i have had mild thyroiditis , and I always have high lymphocytes. For one period of about a year they were raising every month. last two month I had increase the dosge of Eltroxin to be 200 per day because TSH was going up to 9
5 for absorption problems and finally it goes XXXXXXX and last three to two weeks I had bronchitis and fever and toke antibiotic medicine so, my question to you today and as CBC my absolute lymphocytes is 5.14( please find the attachments ) is it really means I have now CLL or shall be waiting for 3 month with level above 5000, is any relation between tsh or t4 and bronchitis and 5000 level.
A Thanks in advance and best regards Hmad
5 for absorption problems and finally it goes XXXXXXX and last three to two weeks I had bronchitis and fever and toke antibiotic medicine so, my question to you today and as CBC my absolute lymphocytes is 5.14( please find the attachments ) is it really means I have now CLL or shall be waiting for 3 month with level above 5000, is any relation between tsh or t4 and bronchitis and 5000 level.
A Thanks in advance and best regards Hmad
Brief Answer:
Explained in details.
Detailed Answer:
Hi, dear
I have gone through your question and reports. I can understand your concern.
Your TSH is normal right now with your eltroxin. Your CBC report suggest high lymphocytes count.
But from this count we can not say whether it is due CLL or viral infection.
Your TSH has no relation with lymphocytosis but bronchitis can leads to lymphocytosis.
So you should repeat your complete blood count after 1 month. If lymphocytes remains persistent high then you should go for immunophenotyping to confirm or rule our chronic lymphocytic leukemia.
Hope I have answered your question. If you have any doubts then feel free to ask me. I will be happy to answer. Thanks for using health care magic. Wish you a very good health.
Explained in details.
Detailed Answer:
Hi, dear
I have gone through your question and reports. I can understand your concern.
Your TSH is normal right now with your eltroxin. Your CBC report suggest high lymphocytes count.
But from this count we can not say whether it is due CLL or viral infection.
Your TSH has no relation with lymphocytosis but bronchitis can leads to lymphocytosis.
So you should repeat your complete blood count after 1 month. If lymphocytes remains persistent high then you should go for immunophenotyping to confirm or rule our chronic lymphocytic leukemia.
Hope I have answered your question. If you have any doubts then feel free to ask me. I will be happy to answer. Thanks for using health care magic. Wish you a very good health.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Thanks alot docotr,can bronchitis after cure cause that 2 weeks after?? i know That in USA they consider high level of absolute lymphocytes 5000 as diagnosis for CLL that correct ??? and if the answer is yes .... shall the duration for having this to be 3 month ?? last is Thyrotoxicosis is also cause high lymphocytis?? best regards
Hamad
Hamad
Brief Answer:
Explained in details.
Detailed Answer:
Hi, dear
Generally bronchitis or any other infection after cure does not cause lymphocytosis.
Everywhere high level of absolute lymphocytes more then 5000 is diagnostic criteria for CLL.
But it should be clonal expansion of B lymphocytes.
Many times infection can leads to high lymphocytes but that are not clonal.
Most of the time in classic CLL, more then 90% cells in peripheral blood are mature lymphocytes.
Moreover diagnosis can be confirmed by immunophenotyping or bone marrow examination.
But as such CLL is chronic disease and there is no emergency so you can wait for a month or two. And just wait and watch your lymphocytes count. If count increases go for immunophenotyping.
Thyrotoxicosis is not related to high lymphocytes count in peripheral blood. So don't worry about that.
Hope I have answered your question. If you have any doubts then feel free to ask me. I will be happy to answer. Thanks for using health care magic. Wish you a very good health.
Explained in details.
Detailed Answer:
Hi, dear
Generally bronchitis or any other infection after cure does not cause lymphocytosis.
Everywhere high level of absolute lymphocytes more then 5000 is diagnostic criteria for CLL.
But it should be clonal expansion of B lymphocytes.
Many times infection can leads to high lymphocytes but that are not clonal.
Most of the time in classic CLL, more then 90% cells in peripheral blood are mature lymphocytes.
Moreover diagnosis can be confirmed by immunophenotyping or bone marrow examination.
But as such CLL is chronic disease and there is no emergency so you can wait for a month or two. And just wait and watch your lymphocytes count. If count increases go for immunophenotyping.
Thyrotoxicosis is not related to high lymphocytes count in peripheral blood. So don't worry about that.
Hope I have answered your question. If you have any doubts then feel free to ask me. I will be happy to answer. Thanks for using health care magic. Wish you a very good health.
Above answer was peer-reviewed by :
Dr. Kampana
Dear Doctor , Thanks a lot for you reply. I am so sorry for too much questions , because i would like to have more information about this so sorry .
1- you mention that Everywhere high level of absolute lymphocytes more then 5000 is diagnostic criteria for CLL. so frankly shall i consider that fro my case?
2- you mention But it should be clonal expansion of B lymphocytes.... so what is clonal and how i know i have 90% or not ??
3-you mention If count increases go for immunophenotyping........ so do you think it may decrees and what shall i do if decrease.
thanks alot doctor and sorry again
best regards Hamad
1- you mention that Everywhere high level of absolute lymphocytes more then 5000 is diagnostic criteria for CLL. so frankly shall i consider that fro my case?
2- you mention But it should be clonal expansion of B lymphocytes.... so what is clonal and how i know i have 90% or not ??
3-you mention If count increases go for immunophenotyping........ so do you think it may decrees and what shall i do if decrease.
thanks alot doctor and sorry again
best regards Hamad
Brief Answer:
Explained in detail.
Detailed Answer:
Hi dear
First of all criteria for high lymphocytes should be used in correlation with other finding. So it is not applicable right now for you.
Expansion should be clonal.
Clonal expansion means it is cancerous and deriving from one cell lineage. Or in simple word it just one cell type that goes uncontrolled proliferation resulting in cancer. And whether it is clonal or not that is identified by immunophenotyping only.
Most of the time lymphocytes are around 90% in CLL. But that is not criteria. You can check your lymphocytes count percentage in your complete blood count report.
If count increase further then there is high chance of CLL so in that case you should go for immunophenotyping.
Your count can decrease if it is due to some infection. In that case nothing to worry. No further investigation required if your lymphocytes count decrease and becomes normal.
If your count decrease only slightly then go for repeat blood count monthly till it comes down to normal.
Hope I have answered your question.
Don't worry much about that. Just be relaxed.
If you still have any questions then feel free to ask me. I will be happy to answer. Thanks for using health care magic. Wish you a very good health.
Explained in detail.
Detailed Answer:
Hi dear
First of all criteria for high lymphocytes should be used in correlation with other finding. So it is not applicable right now for you.
Expansion should be clonal.
Clonal expansion means it is cancerous and deriving from one cell lineage. Or in simple word it just one cell type that goes uncontrolled proliferation resulting in cancer. And whether it is clonal or not that is identified by immunophenotyping only.
Most of the time lymphocytes are around 90% in CLL. But that is not criteria. You can check your lymphocytes count percentage in your complete blood count report.
If count increase further then there is high chance of CLL so in that case you should go for immunophenotyping.
Your count can decrease if it is due to some infection. In that case nothing to worry. No further investigation required if your lymphocytes count decrease and becomes normal.
If your count decrease only slightly then go for repeat blood count monthly till it comes down to normal.
Hope I have answered your question.
Don't worry much about that. Just be relaxed.
If you still have any questions then feel free to ask me. I will be happy to answer. Thanks for using health care magic. Wish you a very good health.
Above answer was peer-reviewed by :
Dr. Kampana
Hi Doctor, I hope you are doing well. I repeated the CBC in 2 different laboratories ( please find the attachments) please let me know what to do after and . also could you tell me if for CLL the absolute lymphocyte reach 5000 is possible to be normal after that or no?? thanks in advance in best regards. XXXXXXX
Brief Answer:
Nothing to worry.
Detailed Answer:
Hi, dear
I have gone through your question and latest reports.
Your both reports are normal now.
So in my opinion no need to worry about CLL right now. Mostly it is due to some infection and now it becomes normal so nothing worry right now.
In case of CLL count generally not decreased. So in my opinion just nothing to worry. No need to do anything. Just be relaxed.
Just repeat your complete blood count once after 3 month to assure. Nothing needed right now.
Hope I have answered your question.
If you have any doubts then feel free to ask me. I will be happy to answer.
Thanks for using health care magic.
Wish you a very good health.
Nothing to worry.
Detailed Answer:
Hi, dear
I have gone through your question and latest reports.
Your both reports are normal now.
So in my opinion no need to worry about CLL right now. Mostly it is due to some infection and now it becomes normal so nothing worry right now.
In case of CLL count generally not decreased. So in my opinion just nothing to worry. No need to do anything. Just be relaxed.
Just repeat your complete blood count once after 3 month to assure. Nothing needed right now.
Hope I have answered your question.
If you have any doubts then feel free to ask me. I will be happy to answer.
Thanks for using health care magic.
Wish you a very good health.
Note: For further queries related to kidney problems Click here.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
