1. Patients launch $1.27 million crowdfunding campaign for ME/CFS gut microbiome study.
    Check out the website, Facebook and Twitter. Join in donate and spread the word!
ME/CFS and the Magic of the Canine Factor
There's been plenty of research indicating that having pets is good for your health. I never really noticed any particular benefits to having cats, though that may have had more to do with my cats. They've been fairly indifferent to my presence and we've shared a live-and-let-live...
Discuss the article on the Forums.

lymphocytes

Discussion in 'XMRV Testing, Treatment and Transmission' started by FernRhizome, Mar 1, 2010.

  1. FernRhizome

    FernRhizome Senior Member

    Messages:
    412
    Likes:
    0
    I know that XMRV has been found in lymphocytes. My normal result on a CBC for lymph is at the very low end of the range, 23 in a range of 20-50. I wondered if that is true of other folks.

    Even more interesting, I recently developed a sinus infection after my cat managed to drool into my nostrils while I was asleep at night (one of those things in life one wishes one could erase, like CFS).

    Now my lymph % is low at 12.5, nearly HALF the low end of the normal range. This sounds pretty severe to me to be 50% outside the range for lymphocytes.

    Does anyone have any knowledge about lymph testing results? And I wonder if XMRV impacts where we fall in the range. And how unusual it is to be 50% below the low end of the range. I'll see my PCP this afternoon. ~Fern
  2. JT1024

    JT1024 Senior Member

    Messages:
    534
    Likes:
    288
    Massachusetts
    As a rule the normals are as below. I work in a clinical laboratory and when I see serious bacterial infections (e.g. sepsis, pneumonia) the neutrophils will be very high and the lymphocytes will be markedly reduced as will other cells. High lymphocyte counts are seen in viral infections and leukemias. A differential is based upon 100 cells so the numbers in a differential represent the percentage of cells in your blood.

    Given you had a sinus infection (probably bacterial), it would make perfect sense that your lymphocyte percentage would go down because your neutrophils would be increased. Hope that makes sense to you. More information is below but it is not exhaustive.

    Differential Normal Results:

    Neutrophils: 40% to 60%
    Lymphocytes: 20% to 40%
    Monocytes: 2% to 8%
    Eosinophils: 1% to 4%
    Basophils: 0.5% to 1%
    Band (young neutrophil): 0% to 3%

    Any infection or acute stress increases your number of white blood cells. High white blood cell counts may be due to inflammation, an immune response, or blood diseases such as leukemia.

    It is important to realize that an abnormal increase in one type of white blood cell can cause a decrease in the percentage of other types of white blood cells.

    An increased percentage of lymphocytes may be due to:

    Chronic bacterial infection
    Infectious hepatitis
    Infectious mononucleosis
    Lymphocytic leukemia
    Multiple myeloma
    Viral infection (such as infectious mononucleosis, mumps, measles)
    Recovery from a bacterial infection

    A decreased percentage of lymphocytes may be due to:

    Chemotherapy
    HIV infection
    Leukemia
    Radiation therapy or exposure
    Sepsis

    More information at:

    http://www.nlm.nih.gov/medlineplus/ency/article/003657.htm
  3. FernRhizome

    FernRhizome Senior Member

    Messages:
    412
    Likes:
    0
    Thank you JT! This is so helpful! So a drop of 50% is not a big deal as long as it isn't long-term? I wonder what is normal in CFS patients? Since that's where XMRV is found and since B and T cells and natural killer cells make up the lymphocytes?

    Also you listed infectious mononucleosis. What about reactivated EBV? Would that cause a drop in lymhocytes? Many thanks for responding with such great info! ~Fern
  4. Anika

    Anika Senior Member

    Messages:
    135
    Likes:
    1
    U.S.
    Thanks for the info JT. It still sounds as if normally you would expect white cells to go up if there were an infection causing a big drop in lymphocytes?

    Any thoughts on why lymphs would go way down (and neutrophils way up, with some other tweaks) while white blood cells stayed normal, no major increase?

    After CFS symptoms, but before diagnosis, I had severe lower right abdominal pain plus other symptoms, with appendicitis a concern. The doctor told me all my blood tests were "normal." Only years later did I see that in fact my lymphs were about a third of normal, with adjustments in neutrophils etc - but my white blood cells were normal, which I think is what my doctor keyed in on. It was never on my list to raise with my new doctor - too many other issues!

    But, seeing this, I wonder if there was anything going on then that a different doctor might have keyed in on, to my benefit.

    Anika
  5. FernRhizome

    FernRhizome Senior Member

    Messages:
    412
    Likes:
    0
    Anika:
    That is interesting as my white blood cell count is ALSO normal but my lymphocytes are at half of normal (12%). I had tons of upper right quadrant pain (URQ) which they never figured out but was always much worse with relapses and in my early years. I think it might have been spleen or liver. ~Fern
  6. Anika

    Anika Senior Member

    Messages:
    135
    Likes:
    1
    U.S.
    Hi Fern,

    Do you mean gallbladder (not spleen) or liver? I think spleen is on left.

    Anika
  7. FernRhizome

    FernRhizome Senior Member

    Messages:
    412
    Likes:
    0
    I am sure you are right. Not gallbladder so I guess just liver...it always was upper right quadrant and I always suspected my liver. I had chemical hepatitis at one point from the antibiotic erthyromcyn and that caused URQ pain and I think for some reason it got inflammed somehow periodically, that's what it always felt like.
  8. JT1024

    JT1024 Senior Member

    Messages:
    534
    Likes:
    288
    Massachusetts
    Fern and Anika,

    Right upper quadrant pain is usually associated with liver disease, gall bladder, or pancreatitis. . Right lower quadrant pain is definitely more appendicitis but can be other things.

    A few things you should know... Everyone one's "normal" is not the same. Having done my own blood work for years, I know what my "normals" are for most routine tests. My total white count (WBC) runs low and always has...at least in my adult life. When I'm sick with say a sinus infection, my white count goes up but not even out of the normal range for most people most of the time. It can almost double and it is still within "normal". What changes is the types of white cells circulating. In bacterial infections, two cell types are predominant: neutrophils and monocytes. In viral infections, you will see more lymphocytes. Even if your WBC count is not elevated but there is a shift in the differential, it can be significant.

    Many doctors do not see what I see. They haven't seen hundreds of patients' cells on a slide. They look at the total WBC count and if it is in the "normal" range. They'll look at the differential and if there are many more neutrophils and monocytes, it is indicative of bacterial infection. They will also be going on clinical findings as well (e.g. fever).

    It really is worth knowing what your test results are and what is normal for you.

    Years ago, I was extremely sick and I had to cancel a business trip because of it. I went to the walk in clinic and they did nothing. Monday morning, I went to my primary care and she wasn't going to do anything either and she hadn't done any testing. I asked her how she could diagnose me when she had done nothing and asked to have a CBC done. I had worked at the teaching hospital for 8 years and she was really ticked off when I questioned her. She ordered the test and I went and had my blood drawn and the test run. Since I worked there for so long, I stood there talking to the techs while they did the count and differential. I was upset but validated when I saw my results. I indeed had had a very serious infection and this doctor and a teaching hospital did nothing until I pushed.

    Today in healthcare, you have to be very assertive and proactive. Your life is at stake. Sometime, google the 1999 Institute of Medicine report "To Err is Human". Also check out the 2001 follow up report "Crossing the Chasm". It will give you an idea of what really happens in healthcare everyday.

    Sorry if I rambled. I just got home from work a little bit ago and my dog is demanding attention!

    Hope I've helped in some way... ~ JT
  9. FernRhizome

    FernRhizome Senior Member

    Messages:
    412
    Likes:
    0
    JT:
    Thank you for your posting. We are so lucky to have you on this forum and it's really helpful to hear more about the meanings behind the mysterious basic blood tests! I always actually thought it would be really cool to work in a hospital lab and do blood testing! So it's really neat that's what you do! I also agree with as to how often doctors don't get basic testing done or even ignore the results. For instance last Saturday I ended up in the ER I was so sick. The ER doc did the basic tests and said all was fine. I asked for a copy of my labs and that's how I found that my lymphocytes were 50% below the bottom range! And like you, it was validating to see that I was really sick! Not that I didn't already know that! But the doctor could have brought that up to as it suggested a bacterial infection.....my infectious disease doctor is MUCH more interested & wants me to now have further testing! But the PCP & ER doc were totally uninterested. I think they see folks get sick and get better so much they know if they ignore it their patient will usually get better. But for us with CFIDS where we are already so low down, a bacterial or additional viral infection is a much bigger problem. Since my recent secondary illness was from a bizarre situation in which I ended up with something from my cat, you've reassured me that if my lymphocytes were low & my WBC was normal then it was indeed bacterial and not viral. Thanks JT!!!!
  10. ldhunter

    ldhunter

    Messages:
    26
    Likes:
    5
    I've also had the mysterious upper right quadrant pain on and off for years. Already had my gallbladder and appendix out. Still have the pain and liverenzymes go up and down. Pain is increased when I over exert myself or a flare is coming on. I now have an enlarged liver, so keeping an eye on that. My csf fluid from my last spinal tap showed I had no lymphocytes or monocytes...Sounds weird to me, but the docs didn't much out of it. "Zero" is not normal, or that number would be included in the range!?
  11. JT1024

    JT1024 Senior Member

    Messages:
    534
    Likes:
    288
    Massachusetts
    Just an fyi...

    You should not have any RBC's or WBC's in your spinal fluid. Normally, spinal fluids are clear, colorless, sterile (no bacteria or viruses), and there are no cells. We usually do cell counts on tubes 1 and 4 (they usuallly fill 4 tubes). Tube 1, being the first filled, will often be contaminated with cells from the actual puncture.

    If the differential on the CSF (cerebrospinal fluid) is pretty much the same in Tube 1 as the peripheral blood smear (diff from a CBC), it is most often just contamination.

    Tube 4 should have no cells in it and most don't. There may a few cells but that wouldn't make me crazy! When you see something like a meningtiis case come in, the CSF can be nasty with many WBC's. Depending on the type you'll see different types of cells. Neutrophils and monocytes are indicative of bacterial infection.

    With all the meds PWC take, we have to be very careful of our livers. We probably don't have our liver function tests checked as often as we should. I know I don't and I can do it anytime I want (while I'm working in a clinical lab anyways!). I was taking a supplement called Kyolic Garlic Formula 105 that was "anti-aging" but it is also for detoxification. I like to have it on hand but I just ran out and haven't had the chance to get more yet.

    My dog has liver disease and is on a special diet and when I read what was in his food, I was thinking perhaps I should be eating his food! It looks pretty nasty though.

    Hope this helps!

    ~ JT
  12. Anika

    Anika Senior Member

    Messages:
    135
    Likes:
    1
    U.S.
    JT, very interesting observations - thank you!

    Good point about knowing what is "normal" for you. But, I'm not sure if I ever got a baseline for what was normal on many tests when I was healthy. Probably it's not standard medical practice. These days, the annual physical doesn't cover much beyond a pap smear (or prostate exam).

    Too bad I didn't work in a lab in my healthy life...

    Sorry about your dog, but sounds like he does ok on his special diet - a lot of pets seem to need them.

    There are days I would be happy to have a bowl of healthy CFS "kibble" , with a choice of beef, liver, etc., and water for my diet. It would keep my teeth healthy too. ;-)

    Anika
  13. Gerwyn

    Gerwyn Guest

    I had upper right quadrand pain for years
  14. Gerwyn

    Gerwyn Guest

    Do you know anything specifically about the immunological connection with scarring and very delayed would healing invariant infection heavy brusing etc---I have that problem even grazes scarr badly and getting worse
  15. JT1024

    JT1024 Senior Member

    Messages:
    534
    Likes:
    288
    Massachusetts
    Hi Gerwyn,

    I don't know specifics but there is a tremendous amount of information on the internet regarding the role of the immune system and healing. I've copied a few abstracts below - none specific to CFS/ME. I've highlighted and italicized mention of immune system function in healing. Where is appears PWC have impaired immune function, it only makes sense bruising is more common. Vitamin K deficiency can also be a cause of easy bruising. Hope this helps!


    Semin Cell Dev Biol. 2009 Jul;20(5):517-27. Epub 2009 Apr 22.
    Interrelation of immunity and tissue repair or regeneration.
    Eming SA, Hammerschmidt M, Krieg T, Roers A.

    Department of Dermatology, University of Cologne, Germany. sabine.eming@uni-koeln.de

    Although tremendous progress has been achieved in understanding the molecular basis of tissue repair and regeneration in diverse model organisms, the tendency of mammals for imperfect healing and scarring rather than regeneration remains unexplained. Moreover, conditions of impaired wound healing, e.g. non-healing skin ulcers associated with diabetes mellitus or vascular disease, as well as excessive scarring, represent major clinical and socio-economical problems. The development of innovative strategies to improve tissue repair and regeneration is therefore an important task that requires a more thorough understanding of the underlying molecular and cellular mechanisms.

    There is substantial evidence in different model organisms that the immune system is of primary importance in determining the quality of the repair response, including the extent of scarring, and the restoration of organ structure and function. Findings in diverse species support a correlation between the loss of regeneration capacity and maturation of immune competence. However, in recent years, there is increasing evidence on conditions where the immune response promotes repair and ensures local tissue protection. Hence, the relationship between repair and the immune response is complex and there is evidence for both negative and positive roles.

    We present an overview on recent evidence that highlights the immune system to be key to efficient repair or its failure. First, we summarize studies in different model systems that reveal both promoting and impeding roles of the immune system on the regeneration and repair capacity. This part is followed by a delineation of diverse inflammatory cell types, selected peptide growth factors and their receptors as well as signaling pathways controlling inflammation during tissue repair. Finally, we report on new mechanistic insights on how these inflammatory pathways impair healing under pathological conditions and discuss therapeutic implications.

    PMID: 19393325 [PubMed - indexed for MEDLINE]

    Surv Ophthalmol. 2000 Jul-Aug;45(1):49-68.
    The role of the immune system in conjunctival wound healing after glaucoma surgery.
    Chang L, Crowston JG, Cordeiro MF, Akbar AN, Khaw PT.

    Wound Healing Research and Glaucoma Units, Institute of Ophthalmology, London, United Kingdom.

    The immune system has a fundamental role in the development and regulation of ocular healing, which plays an important role in the pathogenesis of most blinding diseases. This review discusses the mechanisms of normal wound healing, describing the animal and fetal wound healing models used to provide further insight into normal wound repair. In particular, conjunctival wound repair after glaucoma filtration surgery will be used to illustrate the contributions that the different components of the immune system make to the healing process. The potential role of macrophages, the possible regulatory effect of lymphocytes, and the important role of growth factors and cytokines in the wound healing reaction are discussed. The significance of the immune system in the pathogenesis of aggressive conjunctival scarring is addressed, particularly assessing the predisposing factors, including drugs, age, and ethnicity. The rationale behind the pharmacological agents currently used to modulate the wound healing response and the effects these drugs have on the function of the immune system are described. Finally, potential new therapeutic approaches to regulating the wound healing response are reported.

    PMID: 10946081 [PubMed - indexed for MEDLINE]

    Arch Dermatol Res. 2009 Apr;301(4):259-72. Epub 2009 Apr 10.
    Keloid scarring: bench and bedside.
    Seifert O, Mrowietz U.

    Department of Dermatology, County Hospital Ryhov, Jonkoping 55185, Sweden. oliver.seifert@lj.se

    Wound healing is a fundamental complex-tissue reaction leading to skin reconstitution and thereby ensuring survival. While, fetal wounds heal without scarring, a normal "fine line" scar is the clinical outcome of an undisturbed wound healing in adults. Alterations in the orchestrated wound healing process result in hypertrophic or keloid scarring. Research in the past decades attempted to identify genetic, cellular, and molecular factors responsible for these alterations. These attempts lead to several new developments in treatments for keloids, such as, imiquimod, inhibition of transforming growth factor beta, and recombinant interleukin-10. The urgent need for better therapeutics is underlined by recent data substantiating an impaired quality of life in keloid and hypertrophic scar patients. Despite the increasing knowledge about the molecular regulation of scar formation no unifying theory explaining keloid development has been put forward until today. This review aims to give an overview about the genetic and molecular background of keloids and focus of the current research on keloid scarring with special emphasis on new forthcoming treatments. Clinical aspects and the spectrum of scarring are summarized.

    PMID: 19360429 [PubMed - indexed for MEDLINE]
  16. Dr. Yes

    Dr. Yes Shame on You

    Messages:
    867
    Likes:
    22
    One thing that I recommend having done if at all possible (but that few doctors know how to do) is a careful visual examination of lymphocytes in a peripheral blood smear. This is usually done by hematologists or clinical pathologists to rule out things like lymphocytic malignancies, but a well-trained eye can pick out virocytes, which are lymphocytes that have filament -like "pseudopod" extensions on their membranes. These indicate a response to a virus that may otherwise go undetected.

    In my case, elevated lymphocytes (lymphocytosis) was a persistent finding early in the illness, and a single blood smear taken at just the right time showed virocytes and got my doctor at the time (again, an infectious disease doc) to investigate a broader range of viruses, leading to positive findings for CMV and HHV-6. Unfortunately, not all hematologists know what they are doing; one mistook the virocytes for hairy cell leukemia cells (both have filamentous projections from the membranes that could be called "hair-like"), and I was then put through a bone marrow biopsy and a trip to the Mayo Clinic to rule it out - and he still wasn't entirely convinced!
  17. Gerwyn

    Gerwyn Guest

    thankyou helpful and frightening!
  18. acer2000

    acer2000 Senior Member

    Messages:
    571
    Likes:
    201
    I think relative lymphocytosis and neutropenia are common findings in CFS. Like within the normal range, but getting towards the outer edges. Absolute counts are normal though.
  19. Gerwyn

    Gerwyn Guest

    thankyou helpful and frightening!
  20. JT1024

    JT1024 Senior Member

    Messages:
    534
    Likes:
    288
    Massachusetts
    Picture of Reactive Lymphocytes

    Thought some of you might like to see what the lymphocytes look like on a peripheral smear.

    Reactive lymphocyte, viral infection blood

    A Reactive Lymphocyte in each frame. Reactive lymphocytes are medium-to-large in size and show much more cytoplasm than usual lymphocytes. The cell outline may or may not be irregular. Cytoplasmic color is gray or gray-blue, frequently showing increased basophilic color at the periphery. Vacuoles and/or azurophilic granules may be present. The nucleus is frequently irregular (oval, elliptical, triangular, indented, overlapping) in shape. Chromatin often is less dense and/or more evenly distributed than in the usual lymphocyte. A nucleolus may be seen. Viral infection blood - 100X

    [​IMG]

See more popular forum discussions.

Share This Page