From the Guidelines
This patient's blood test results indicate a potential hypereosinophilic syndrome (HES) due to the elevated eosinophil percentage (eo% 6.6%) and absolute count (eo# 0.30), which requires further evaluation and possible referral to a specialist, as indicated by the 2020 guidelines for myeloid/lymphoid neoplasms with eosinophilia and TK fusion genes 1.
The key findings in this patient's blood test include:
- Elevated hematocrit (HCT) at 45.6%, which is slightly above the normal range
- Lymphopenia (low lymphocyte count) at 0.97 K/µL
- Elevated monocytes (both percentage and absolute count)
- Elevated eosinophils (percentage and absolute count)
- Slightly elevated basophils (percentage)
These abnormalities could suggest an inflammatory or allergic process. The elevated monocytes might indicate an ongoing infection, inflammation, or possibly a recovering state from a recent illness. The increased eosinophil percentage could point to an allergic reaction, parasitic infection, or certain inflammatory conditions, such as HES, as defined by the 2020 guidelines 1. The low lymphocyte count might be due to stress, certain medications, or viral infections.
Given the potential for HES, it is essential to consider the criteria for diagnosis, which include peripheral blood hypereosinophilia, organ damage and/or dysfunction attributable to tissue hypereosinophilia, and exclusion of other disorders or conditions as the major reason for organ damage, as outlined in the 2020 guidelines 1.
The patient's elevated eosinophil count and percentage, along with other abnormalities, warrant further investigation to determine the underlying cause and to assess for any end-organ damage. This may involve additional testing, such as molecular studies to identify any TK fusion genes or other underlying conditions, and a thorough clinical evaluation to assess for any signs or symptoms of end-organ damage.
A comprehensive evaluation and possible referral to a specialist are recommended to determine the underlying cause of the elevated eosinophil count and to assess for any potential end-organ damage, as indicated by the 2020 guidelines for myeloid/lymphoid neoplasms with eosinophilia and TK fusion genes 1.
From the Research
Blood Test Results
The provided blood test results show the following values:
- WBC: 4.54 K/µL (within normal range of 3.98-10.04 K/µL)
- RBC: 4.94 M/µL (within normal range of 3.93-5.22 M/µL)
- HGB: 14.7 g/dL (within normal range of 11.2-15.7 g/dL)
- HCT: 45.6 % (high, normal range is 34.1-44.9 %)
- MCV: 92.3 fL (within normal range of 79.4-94.8 fL)
- MCH: 29.8 pg (within normal range of 25.6-32.2 pg)
- MCHC: 32.2 g/dL (within normal range of 32.2-35.5 g/dL)
- PLT: 239 K/µL (within normal range of 182-369 K/µL)
- MPV: 12.1 fL (within normal range of 9.4-12.3 fL)
- Neutrophil percentage: 56.6 % (within normal range of 34.0-71.1 %)
- Neutrophil count: 2.57 (within normal range of 1.56-6.13)
- Lymphocyte percentage: 21.4 % (within normal range of 19.3-51.7 %)
- Lymphocyte count: 0.97 K/µL (low, normal range is 1.18-3.74 K/µL)
- Monocyte percentage: 13.9 % (high, normal range is 4.7-12.5 %)
- Monocyte count: 0.63 (high, normal range is 0.24-0.56)
- Eosinophil percentage: 6.6 % (high, normal range is 0.7-5.8 %)
- Eosinophil count: 0.30 (within normal range of 0.04-0.36)
- Basophil percentage: 1.3 % (high, normal range is 0.1-1.2 %)
- Basophil count: 0.06 (within normal range of 0.00-0.08)
- RDW-CV: 12.1 % (within normal range of 11.7-14.4 %)
- Ig percentage: 0.200 % (within normal range of 0.000-1.500 %)
- Ig count: 0.010 (within normal range of 0.000-0.093)
- NRBC percentage: 0.0 % (within normal range of 0.0-0.2 %)
- NRBC count: 0.000 (within normal range of 0.000-0.012)
Interpretation of Results
According to the study 2, a complete blood cell count (CBC) is one of the most common laboratory tests in medicine, and it is essential to have a structured action plan when confronted with abnormal CBC results. The provided results show some abnormal values, such as high HCT, low lymphocyte count, high monocyte percentage and count, high eosinophil percentage, and high basophil percentage.
The study 3 provides reference values for white blood cell count, differential, and other blood parameters. The study suggests that age and sex-dependent differences should be considered when interpreting these values. The provided results do not specify the age and sex of the patient, making it difficult to determine the significance of the abnormal values.
The study 4 discusses the approach to eosinophilia from an infectious diseases perspective. The high eosinophil percentage in the provided results may indicate an infectious disease, but further investigation is needed to determine the cause.
The study 5 evaluates the use of common blood parameters for the differential diagnosis of childhood infections. The study suggests that a combination of blood parameters, including CRP, HGB, PLT, eosinophil, monocyte, and lymphocyte counts, can distinguish between infectious pathogens in children. The provided results show some abnormal values, but it is unclear whether these values are related to an infectious disease.
Possible Causes of Abnormal Values
The abnormal values in the provided results may be caused by various factors, including:
- Infections: The high eosinophil percentage and high monocyte percentage and count may indicate an infectious disease 4, 5.
- Inflammatory conditions: The high HCT and low lymphocyte count may indicate an inflammatory condition.
- Other medical conditions: The abnormal values may be related to other medical conditions, such as blood disorders or autoimmune diseases.
It is essential to consider the patient's medical history, physical examination, and other laboratory results to determine the cause of the abnormal values. Further investigation and consultation with a healthcare professional are necessary to interpret the results and develop a treatment plan.