From the Research
Introduction to Lab Interpretation
The interpretation of labs showing leukocytosis, hyperchromia, low RDW CV, lymphocytosis, basophilia, and hyperferritinemia requires a comprehensive approach to identify the underlying cause of these abnormalities.
Leukocytosis
Leukocytosis, an elevation of the white blood cell count, can be caused by various conditions, including infections, inflammatory processes, and primary bone marrow disorders 1, 2, 3. The presence of leukocytosis should prompt further investigation to identify the underlying cause.
Hyperchromia and Red Blood Cell Parameters
Hyperchromia, an elevation of the hyperchromic red blood cell subpopulation, has been associated with decreased red cell deformability and can be seen in various medical conditions, including hereditary spherocytosis and viral infections 4. A low RDW CV, which indicates a uniform red blood cell size, can be seen in conditions such as iron deficiency anemia or blood loss.
Lymphocytosis and Basophilia
Lymphocytosis, an elevation of the lymphocyte count, can be seen in viral infections, allergic reactions, and other conditions 3, 5. Basophilia, an elevation of the basophil count, can be seen in conditions such as allergic reactions, parasitic infections, and primary bone marrow disorders 1, 2.
Hyperferritinemia
Hyperferritinemia, an elevation of the ferritin level, can be seen in conditions such as iron overload, inflammation, and primary bone marrow disorders.
Differential Diagnosis
The differential diagnosis for these lab abnormalities includes:
- Infections (bacterial, viral, or parasitic)
- Inflammatory conditions (e.g., rheumatoid arthritis, lupus)
- Primary bone marrow disorders (e.g., leukemia, lymphoma)
- Allergic reactions
- Hereditary spherocytosis
- Iron deficiency anemia or blood loss
Treatment and Management
Treatment and management of these lab abnormalities depend on the underlying cause. For example:
- Infections may require antibiotic or antiviral therapy
- Inflammatory conditions may require anti-inflammatory medications or immunosuppressive therapy
- Primary bone marrow disorders may require chemotherapy, radiation therapy, or bone marrow transplantation
- Allergic reactions may require antihistamines or corticosteroids
- Hereditary spherocytosis may require splenectomy or other supportive measures
Caveats
It is essential to consider the clinical context and medical history of the patient when interpreting these lab abnormalities. Further testing, such as a bone marrow biopsy or imaging studies, may be necessary to establish a definitive diagnosis. Referral to a hematologist/oncologist may be indicated if a primary bone marrow disorder is suspected 3.