Elevated blood cell parameters secondary to smoking.

Resolved question:
Hello, I have had consistently elevated blood levels per the below over the last 5 months. I have been told to see a hematologist. I am a 42 year old women, smoker. What could these results mean?

immature granulocytes 0.04
wbc 11.9
platelets 433,
neutrophils 8.5
Bun 24
ERYTHROCYTE SEDIMENTATION RATE - 24
LAP score 228

I am making an appointment with the hemotologist but wanted to get an idea.

Thank you

Submitted: 4 Days
Category: Hematologist

Expert:  Dr. Prasad Eswaran replied 4 Days.

Hello,
Thankyou for approaching DoctorSpring with your query. ,

Please can you let me know your hemoglobin levels.
Do you have any peripheral smear report study done earlier? As per attached reports, I suspect smoking to be a cause for the present elevated levels. I would like to know how many years have you smoked and type of smoke and how many did you smoke per day all these years.
However, I would like to have a complete blood work investigation done before commenting on the complaints. Kindly forward/upload all the blood work and investigations that you have done so that I can guide you better.

Please reply as a follow up.

Regards


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Patient replied :

Component Results
Component Standard Range Your Value
ESR 0 - 18 mm/hr 24
General Information
Collected:
02/27/2014 10:43 AM
Resulted:
02/27/2014 10:04 PM

VITAMIN B12 AND FOLATE LEVELS - Details


Reference values are the expected results for patients. Values outside the reference value do not necessarily indicate disease. More information is available in the Laboratory Test Directory and from your physician. To learn more about Beaumont Laboratory, click here.

Component Results
Component Standard Range Your Value
Vitamin B12 271 - 870 pg/mL 626
Folate >5.4 ng/mL 19.2
General Information
Collected:
02/27/2014 10:43 AM
Resulted:
02/27/2014 9:53 PM
VITAMIN B12 AND FOLATE LEVELS - Details


Component Results
Component Standard Range Your Value
Vitamin B12 271 - 870 pg/mL 626
Folate >5.4 ng/mL 19.2
General Information
Collected:
02/27/2014 10:43 AM
Resulted:
02/27/2014 9:53 PM

COMPREHENSIVE METABOLIC PANEL (CMP) - Details


Reference values are the expected results for patients. Values outside the reference value do not necessarily indicate disease. More information is available in the Laboratory Test Directory and from your physician. To learn more about Beaumont Laboratory, click here.

Component Results
Component Standard Range Your Value
Sodium 135 - 145 mmol/L 137
Potassium 3.5 - 5.2 mmol/L 4.3
Chloride 95 - 107 mmol/L 102
Carbon Dioxide (CO2) 21 - 31 mmol/L 24
Anion Gap 5 - 17 11
Glucose 60 - 99 mg/dL 118
Blood Urea Nitrogen (BUN) 8 - 22 mg/dL 24
Creatinine 0.60 - 1.40 mg/dL 0.81
GFR Non African American >59 mL/min/1.73m2 78
GFR African American >59 mL/min/1.73m2 94
Calcium 8.5 - 10.5 mg/dL 9.6
Protein Total 6.4 - 8.6 g/dL 7.0
Albumin 3.5 - 5.1 g/dL 4.6
Globulin 2.2 - 4.0 g/dL 2.4
Albumin/Globulin Ratio 1.9
Alkaline Phosphatase (ALP) 30 - 110 U/L 75
Aspartate Aminotransferase (AST) 10 - 37 U/L 20
Alanine Aminotransferase (ALT) 8 - 37 U/L 26
Bilirubin Total 0.3 - 1.2 mg/dL 0.2
General Information
Collected:
02/27/2014 10:43 AM

COMPLETE BLOOD COUNT W DIFF - Details


Reference values are the expected results for patients. Values outside the reference value do not necessarily indicate disease. More information is available in the Laboratory Test Directory and from your physician. To learn more about Beaumont Laboratory, click here.

Component Results
Component Standard Range Your Value
WBC 3.3 - 10.7 bil/L 11.9
RBC 3.87 - 5.08 tril/L 4.22
Hemoglobin 12.1 - 15.0 g/dL 12.4
Hematocrit 35.4 - 44.2 % 36.5
MCV 80 - 100 fL 87
MCH 28 - 33 pg 29
MCHC 32 - 35 g/dL 34
RDW SD 40 - 50 fL 44
RDW CV 12 - 15 % 14
Platelets 150 - 400 bil/L 433
Neutrophils 1.6 - 7.2 bil/L 8.5
Lymphocytes 1.1 - 4.0 bil/L 2.6
Monocytes 0.0 - 0.8 bil/L 0.7
Eosinophils 0.0 - 0.5 bil/L 0.1
Immature Granulocytes 0.00 - 0.03 bil/L 0.04
General Information
Collected:
02/27/2014 10:43 AM

LEUKOCYTE ALKALINE PHOSPHATASE - Details


Reference values are the expected results for patients. Values outside the reference value do not necessarily indicate disease. More information is available in the Laboratory Test Directory and from your physician. To learn more about Beaumont Laboratory, click here.

Component Results
Component Standard Range Your Value
LAP SCORE 30 - 90 228
General Information







Expert:  Dr. Prasad Eswaran replied 3 Days.

Dear. ,

I see all your investigations normal except for mildly elevated neutrophil counts and a correspondingly elevated LAP which may be due to mild / symptomatic / asymptomatic infections most commonly. These may happen and values change now and then as body immunity fights against the infection. Please let me if you have any specific symptoms or clinical problems so as to ascertain the reason for such mild elevations.

Hope this clears your query.

Kind regards

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