/r/Hematopathology

Photograph via snooOG

A subreddit for individuals with an interest in the diseases of the hematopoietic system, coagulative disorders, and/or management of the hematology laboratory.


Community Rules

  1. Please be professional and courteous.
  2. Stay HIPAA compliant.
  3. No spamming.
  4. Keep it erudite.

Posting Guidelines

  • If posting a journal article, please try to link to the article itself if it is available free online.

  • If the article is not available for free, but is significantly noteworthy, please post the link to the pubmed abstract.

  • Please do not solicit specific medical advice. If you have a health concern, see your physician.

Related Subreddits

External Links

/r/Hematopathology

670 Subscribers

1

Do these look concerning? WBC

Hi all, just looking for some reassurance here. Do these look concerning to you? I had Covid recently and I am 10 weeks pregnant. %lymphocytes have been a bit low for some time, but the rest was ok until today.

Just looking to know if I should be worried. Thank you

https://preview.redd.it/dwvvh0ryvnj91.jpg?width=737&format=pjpg&auto=webp&s=7e8f05c0419ba853116ef1eb0968cceae9d9ae65

2 Comments
2022/08/24
13:15 UTC

1

Xarelto/Eliquis effectiveness?

Does anyone know if there is a recommended blood test to check and see if Xarelto or Eliquis are working properly?

Also, is it possible to have a negative D-Dimer while on a DOAC, but still be clotting?

0 Comments
2022/08/19
03:04 UTC

0

Abs mono auto level high but monocytes % is in normal range ?

Can anybody tell me why on my blood tests my Abs mono auto level is .10 over the average but my monocytes % is 7.7 which is in the normal range of 2%-8%. I have my follow up doc app next Friday but can’t get anybody to message me back about it. All my other levels are in normal range blood wise.

0 Comments
2022/06/30
02:53 UTC

3

Iron metabolism and infection

Links/keywords appreciated, I'd like to read up more.

Can someone explain how the iron serum indices are related to iron in body and infection? Not understanding the pathway.

I'm not sure how Hb, RBC, ferritin TIBC and Serum iron (transferrin Bound Fe??) are related.

What is intracellular and what is extra cellular. What is available for pathogens ( those that want iron eg fungi)

Can ferritin be high but serum iron be low? Is serum iron and tibc always inversely proportional or just in iron def anemia? Possible to have high ferritin in anemia during infection?

1 Comment
2022/06/21
12:19 UTC

0

Recent Leukopenia with no symptoms. Can anyone explain my results? Should I be worried about Leukemia?

Age: 25 Gender: Female Height: 5'3 Weight: 160lb Race: Hispanic

Recent Leukopenia diagnosis with no symptoms referred to Hematologist.

No recent/current illnesses. Not on any medications. Non Smoker/drinker. Currently in the US.

Went for annual routine labs. WBC came back low and PCP referred me to a hematologist who requested more lab tests along with a Flow Cytometry test. Below are my results. Should I be concerned about cancer? What could be causing this since I do not feel ill and do not often get sick.

WBC 4.8-10.8 k/ul

5/16/22: 2.5 k/ul

5/5/22: 3.4 k/ul

4/22/22: 3.1 k/ul

Neutrophil # 1.90-8.00 k/ul

5/16/22: 0.62 k/ul

5/5:/22 0.97 k/ul

4/22/22: 0.71 k/ul

Segmented Neutrophil % 45.0-70.0%

5/16/22: 24.4%

Lymphocyte # 0.90-5.00 k/ul

5/16/22: 1.59 k/ul

5/5/22: 2.03 k/ul

4/22/22: 2.06 k/yl

Lymphocyte % 25.0-40.0%

5/16/22: 62.6%

Flow Cytometry results

  1. Neutropenia
  2. Slightly increased T-cells immunophenotypically compatible with T-cell large granular Lymphocytes/ T-LGL (CD4+/CD57+ cells are 3% of leukocytes (see comments)

Comments: relatively increased T-LGLs may be secondary /reactive. Additionally, clonal T-LGLs may be seen in asymptomatic or minimally symptomatic patients with cytopenias and patients with a variety of clinical conditions. Correlation with available clinical, laboratory, and morphologic data is recommended.

Myeloid Blasts: <0.1% no significant blast population detected

Lymphocytes: 60%

B-cells 6% with polytpic sig light chain pattern

CD4+ T-cells: 31.3% (including 3.0% CD57+ cells - slight relative increase)

CD8+ T-cells 15.8% - slight relative increase (including 1.1% CD57+ cells)

CD4:CD8: 2.0

NK cells 4%

Neutrophils: 27% decreased with few left-shifted forms

Monocytes: 7% no abnormalities of the markers testes

Eosinophils: 3% no relative increase

Basophils: 0.7% no relative increase

CD45 Negative Events/Debris: no significant reactivity with markers tested.

2 Comments
2022/05/20
14:02 UTC

5

Low Ferritin, High Iron

Hello,

39 YO Male, and just got blood tests back that revealed:

  • Iron 197 (exceeds normal range of 180)

  • TIBC 338 (Normal range)

  • Iron Saturation 58% (above normal range of 48%)

  • Ferritin 23 (Below normal range of 30)

My doctor seems perplexed at how I have high iron — meaning I’m not anemic — but below normal range for ferritin.

Has anyone seen this before? Thoughts or advice?

8 Comments
2022/05/18
13:32 UTC

1

Antibodies

I am confused about antibodies being a reason for it being hard to find blood for someone who needs a transfusion? If someone has antibodies, why do they need the donor blood to have the same antibodies?or antigens?

I have had 11 blood transfusions in the last two years… my last two were just a few days ago, and before that I had 4 in December. I had no issues finding a donor before. This time around they said I have 3 antibodies and my blood was reacting to all the donors and they couldn’t find a match. Does this mean I have something wrong?

4 Comments
2022/04/02
03:46 UTC

1

High RBC and HCT. Jak2 negative. Should I be worried?

28 Comments
2022/02/22
18:08 UTC

2

anyone know what this means?

2 Comments
2022/01/13
18:52 UTC

2

Abnormal bloodwork, can’t see a hematologist for a month

Hi I was wondering if someone could give me some guidance. I’m a 25 year old female with endometriosis and microscopic colitis. Since 2016 I’ve had an elevated WBC and no clear reason why. I do get infections very easily (sinus infections, UTIs, yeast infections, I’ve had c. Diff before, etc.). Two weeks ago I had some bloodwork done and my WBC has gone up in the past 5 months, and my eosinophils and neutrophils are elevated. My C-reactive protein is elevated as well. I can’t see a hematologist for a month and my GI doc doesn’t know what to make of it. I have a collection of unexplained symptoms; tingly sensations, tremors, lightheadedness, upper abdominal tightness, and a weird dark area on my ankle. No idea if those symptoms are related to my bloodwork or what. Can anyone give me some guidance? What do elevated eosinophils and neutrophils mean? What can I expect from the hematologist? What should I ask about?

1 Comment
2021/09/28
08:13 UTC

1

Query about abnormal labs

85 yo F with unexplained atraumatic bruising to BLLE and BLUE. Acutely pt noticed new bruising to RUE today. Pt on no blood thinners. Pt has poor diet. No systemic sx. Afebile. No hematuria, no rectal bleeding.

Pmhx: sjogrens, alzheimers, hypothyroidism.

Labs: wbc 6.8. H/h 7.9/26.1. Mcv: 88.5 Plt: 308. Pt: 1.2. Aptt: >400. Ret 3.47. Ldh: pending. Normal lfts. Guaiac neg. clean urine.

Aptt is being repeated. Pathology review pending.

H/h now 7.1/24.something.

Pt transferred and no longer in my care. I’m sure theres more tests to be done. Thoughts as to dx?

1 Comment
2021/08/17
06:07 UTC

3

Doctors seem stumped, not sure how to proceed.

2 Comments
2021/04/18
16:31 UTC

2

NEUTROPHIL

0 Comments
2021/03/18
02:08 UTC

4

What is the difference between FVIII:C and FVIII:Ag?

I know they stand for factor 8 coagulant and factory 8 antigen but what does this exactly mean? And what’s the difference between the two? Can someone please elaborate? This is in the context of haemophilia btw. Thank you!

0 Comments
2020/09/10
01:27 UTC

1

Pathologist Perspective CGP Survey

We are conducting a survey to better understand pathologist perspectives on molecular diagnostics for cancer biomarker testing, with an emphasis on comprehensive genomic profiling (e.g., >50 gene panels) in community hospital settings within the United States.If you are open to participating in our survey campaign please reach out to me and I will send you a link to the survey. The survey requires completing ~8 screener questions to confirm qualification for this survey. You can find project details below:Project details:

Compensation: 120 USD (200 USD if completed before Thursday 7/30)

Median Duration: ~25 minutes

Please email sanghvi@decibio.com for more information

0 Comments
2020/07/28
22:36 UTC

2

Hairy cell Leukemia (Why do hairy projections develop in hairy cells? ) - Rapid Review

0 Comments
2020/06/16
19:59 UTC

1

My blood test

Hello,

I recently got a blood tests and i was looking at the results. Never had low white blood cell count before, so I was wondering if these results were anything to worry about.

WBC # Bld Auto 3.7 L

Neutrophils # Bld Auto 1443 L

Thanks

0 Comments
2020/06/11
18:54 UTC

0

Not worried about COVID-19 while I wait on the test result for polycythemia

It started with my (M/52) TIBC level elevated. Follow-up tests shows my iron is high at 182 along with red blood count high at 5.84, hemoglobin high at 17.7 and my hematocrit high at 51.6. My platelet count is low at 138. All of these are just out of range right now. If it is not polycythemia then it is something equally as bad to have all these test out of whack. It can't be nothing.

0 Comments
2020/06/05
13:07 UTC

1

Any suggestions for assistance

Hi everyone, I hope that you are all staying safe during these hard times. The reason for my post is that my friend's father has been in hospital because if a hematoma in his brain. They drained some of it off and tried to flush the rest with medication. A few days ago after a rough week of on a ventilator and life support, he miraculously woke up. He is having trouble saying any words and sleeps alot. My question is , what can we expect when he is released in a couple of months. What support will we need to give ? Any help or information will be much appreciated. Stay safe!

2 Comments
2020/05/19
20:18 UTC

1

If exercise raises hemacrit then why do people with polycythemia feel better after exercise?

0 Comments
2020/02/28
19:16 UTC

2

Have you experienced or know of anyone who has experienced blood clots during pregnancy?

Hello members,

We are a group of researchers from Mount Sinai Hospital, Toronto and the University of Toronto, located in Toronto, Ontario, Canada. We are currently conducting an online, anonymous survey to learn what health outcomes matter the most to women who have experienced or been at risk for blood clots during pregnancy.

Our main goal is to improve health outcomes for mothers and babies in high risk pregnancy conditions. We would like to ask the members of your website/blog to contribute to our study by participating in an online, anonymous survey sharing their experience in relation to patients who have experienced or been at risk for blood clot development during pregnancy.

The link to our survey is here: https://delphimanager.liv.ac.uk/COSPVenTE/ and you can visit our website for more information here: https://www.obgyn.utoronto.ca/oros-project.

If you have any questions, please do not hesitate to post in the comment section or contact our lead researcher, Dr. Rohan D’Souza at dsouza.research.msh@sinaihealthsystem.ca

We hope you will be willing to participate in this important project and we look forward to hearing from you.

With thanks,

The OROS Team

0 Comments
2020/01/24
01:36 UTC

1

Underfilled EDTA and MCV/MCHC

Increased MCHC is often seen with underfilled EDTA tubes. I always thought this made sense because the EDTA is hyperosmolar to blood - the cell 'shrinks' and MCV goes down so MCHC goes up. But then I got confused when when thinking about it in comparison to in vivo hyperosmolarity.

Why doesn't in vitro erythrocyte dehydration from underfilled EDTA tubes result in an increased MCV when ran on an automated analyzer? I understand that the cells will 'shrink' in the tube, but why don't they 'swell' when placed in the diluent like in vivo hyperosmolar samples?

This is my understanding of hyperosmolar samples:
If a patient is hypernatremic or hyperglycemic, one might expect to see an increased MCV due to in vivo 'shrunken' RBCs and in vitro 'swelling' when the cells are placed in the diluent of an automated analyzer. Because MCHC is calculated using Hct (MCV x RBC), the MCHC may be falsely decreased in hyperosmolar patients. The reverse is true for hypoosmolar patients.

0 Comments
2019/09/04
06:33 UTC

1

5 YO with Elevated Hematocrit and Hemoglobin. Questions.

Hello,

I was wondering if anyone could give me an insight to what this means for my son. A little history. He was anemic (pretty heavily) so the doctors recommended and prescribed iron sups. After taking the sups for a few months his iron levels came back to normal according to his blood tests. However his hemoglobin and hematocrit where elevated. At the time of the first blood draw we had just got back from a trip to Denver and the hematologist suggested he had elevated numbers due to the elevation. This was three months ago and just got tested again two days ago and the doctor said his numbers where still elevated and even slightly higher than before and we have not traveled since.

She said she wasn’t concerned but want to try a few other tests in a few weeks but everything else looked normal as far as organ function and other levels. Even though she said she isn’t worried she did say she wants to find out what it could be that’s elevating it. The question I had was does anyone have any ideas of possibilities? Below are his levels from January this year. I do not have the results other than verbal from the doctor from a few days ago yet. Thanks as always.

Hematocrit 44% Hemoglobin 14.6 g/dl RBC 5.32

2 Comments
2019/05/24
23:31 UTC

3

Atypical Cells

0 Comments
2019/05/09
08:00 UTC

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