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Thanks in advance...

My medical history consists of Celiac Disease (november 2009) and a pacemaker for bradycardia/dysautonomia (oct 2008) caused by untreated Celiac nerve damage. I am also 24 years old and male.

Over the last year, my WBC has always been between 4-6 (normal 4-11), absolute lymphocytes have been chronicaly low at 700-1200 (normal 1500-4000) and my RBC has been between 3.5-4.6 (normal 4.6 - 6.0).

During fall 2009 my retic count was also checked and my absolute retic was at 14 (ref range 25-80). I was sent to a hematologist to get a bone marrow biopsy and one month before my appointment I was diagnosed with Celiac Disease. The hematologist retested my blood before the BMB and my RBC came back at 4.5 (normal 4.6 - 6.0) and my retic dropped to 13 (normal 25-80). She told me that the retic is not concerning enough to her for a BMB because my RBC is normal and she said Celiac may be the cause and sent me on my way.

Since my Celiac diagnosis my RBC has stayed around 4.2 - 4.5 consistantly and my WBC has stayed around 4-6, with absolute lymphocytes still hanging low around 1000. I recently had another full checkup and here were my results:

[COLOR="Red"]RBC: 4.4 (ref range 4.6 - 5.6)[/COLOR]
Hemoglobin (HGB): 135 (range 130 - 170)
[COLOR="red"]Hematocrit (HCT): 38.5 (range 39 - 50)[/COLOR]
PLT: 190 (range 140-400)

ABS Retic: 15 (range 25 - 85)

WBC: 5.76 (range 4.5 - 11)
ABS Neutrophils: 4.19 (ref range 2.0 - 6.3)
[COLOR="Red"]ABS Lymphocytes: 0.65 (ref range 1.5 - 3.5)[/COLOR]
ABS Monocytes: 0.57 (ref range 0.2 - 0.8)
ABS Eosinophils: 0.31 (ref range 0.04 - 0.4)
ABS Basophils: 0.03 (ref range 0.00 - 0.1)

B12: 276 (range 220 - 1000)
Ferritin: 71 (range 50-80=reduced, >80=normal)


Also during my checkup I had a full body ultrasound to check for lymph nodes and some were found in my neck (largest 1.8cm x 0.8cm) and armpit (largest 2.5cm x 0.8cm). The lymph nodes were large, but appeared benign. The only worrisome looking lump was a small 8mm ill defined hypoechoic nodule was found on my thyroid and is being followed in 6 months intervals. My thyroid, vitamin and other panels were checked, which were all normal.

[COLOR="Red"]Does anybody know why my retic would remain low, lymphocytes always low (now worse) with my RBC and WBC always remaining borderline low to low normal?[/COLOR]

My GP is confused at my results, but is unsure whether another trip to the hematologist is warranted or not. I feel like a BMB is needed even though I am not anemic. I feel run down all the time and I feel like the retic has a reference range for a reason. Any help is appreciated.

Thanks.





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