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Dr. SH
Dr. SH, Board Certified Physician
Category: Medical
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Experience:  Doctor of Medicine
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This may appear rambling, but my medical history has been compounded

Resolved Question:

This may appear rambling, but my medical history has been compounded by numerous inefficiencies.
At the age of 10 I was taken to see a paediatrician, who was conspicuous by his absence. He left his secretary in charge and she thought it a good idea to leave me in the waiting room while she interviewed my mother. I was only called in at the very end and was asked "do you worry a lot"
My mother interjected before I could reply and said no. Children should be seen and not heard.
This must be common in children- how did he know without even seeing me.
Had she interviewed me fully and properly I would not be in the predicament I now find myself. Other being very ill with Measles/Rubella at 18 months old and needing spectacles at infant school.
The symptoms I have are as follows:-
• Worry a lot (I did not make this up the royal college of physicians did) Whatever it is it appears different in children, and is physical not psychological and is not taught to British general practitioners. Now I worry about other people think, plus not knowing what is wrong is frightening.
• I was unable to swallow fluids until aged 19. I had got used to drinking the absolute bare minimum. And totally unaware of it until recently.
• eyesight is now very poor.
• No concentration or memory.
• Difficulty in reading and writing.
• Diarrhoea with occasional mishaps.
• Inability to get to sleep and then get up in the morning.
• Difficulty with reading and writing.
• No power, strength or stamina.
• Biting or grinding my teeth together.
• Always hungry and then becoming tired after eating.
• Irritability/short tempered.
etcetera, etcetera.
I thought it was hyperthyroidism, but tests show this not to be the case and I do not have boundless energy, quite the opposite.
I have had some private blood checks done a CBC and lymphocytes checks done. My doctor says they did not show up 3 years ago and they need to be done again. Additionally I have been taking a drug called terbinafine for a toenail that is badly infected with athletes foot, and that this is probably why blood tests could read incorrectly (I do not think so). I am not sure if a CBC and Lymphocytes check is routinely taken. I very much doubt it.
I will upload the private blood tests if this would help you give a diagnosis.
if not lymphocytes What else could it be?
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. Phil, MD replied 3 years ago.
Hello. I'm Dr. Phil, licensed and practicing internist. Excellent service is my goal.
still need help?
Customer: replied 3 years ago.
Relist: Answer quality.
This is the Dr who is very goo. Have dealt with him before
Ask Dr. Shahzad MD Your Own Question
Please re-direct Question to him.
Customer: replied 3 years ago.

of course

Expert:  Dr. Phil, MD replied 3 years ago.
Do you suspect this to have a psychological component at all?
Customer: replied 3 years ago.
Relist: Answer quality.
This is A GP I want a paediatric Haematologist
or just a haematologist. I need to upload blood tests
in PDF format.
Customer: replied 3 years ago.

LYMPHOCYTE SUBSETS


























































































































































































Test



Result



Units



Range









HAEMATOLOGY PROFILE













WHITE CELL COUNT



* 13.77



xlO-9/L



3.0 -



10.0





Lymphocyte count



* 4.94



xlO*9/L



1.2 -



3.65





Lymphocytes Percentage



♦ 35.9



'i









LYMPHOCYTE IMMUNOPHEHOTY PE













CD3 percentage



72.8



i



57.22 -



86.8





CD3!T Lymphocytes)



* 3.60



xlO N9/L



0.87 -



2.51





CD3(T Lymphocytes)



* 3596



cells/uL



870 -



2510





CD4 percentage



42 .1



%



29.0 -



61.0





CD4



* 2.08



xlO"9/L



0.44 -



1.47





§§4



* 2080



cells/uL



440 -



1470





CD8 percentage



* 49.1



%



15.89 -



40.37





CD8



* 2.43



xlO'9/L



0.29 -



I.C5



ft



CD8



- 2426



cells/uL



290 -



1050





CD4/CD3 percentage



41.4



%



30.58 -



60.31





CD4/CD3 (Helper T Lymphs)



4 2.05



xlOA9/L



0.56 -



1.46





CD4/CD3(Helper T Lymphs)



* 2045



•cells/uL



560 -



1460





CD8/CD3 percentage



* 37.7



'%



9.8 -



36.47





CD8/CD3(Cytotoxic T Lymph;



* 1.86



xl0"9/L



0.25 -



0.99





CD8/CD3(Cytotoxic T Lymph)



* 1862



cells/uL



250 -



990





CD4/CD3 ratio



1.10





0. £4 -



2. 97






The total number of lymphocytes were above normal and the subsets were outside of the reference ranges.

We advise that you see your doctor with these results.

One Doc but better in PDF format. Lymphocyte Subsets

CBC to follow

Customer: replied 3 years ago.

COMPLETE BLOOD COUNT





















































































































































































1™.............

I



Test



Result



Units



Rai



ige





HAEMATOIOGY PROFILE











Red Blood Cells



HAEMOGLOBIN (g/L)



15S c



g/L



130



- 170





HCT



0.432





0.37



-0.50





P.ED CELL COUNT



4 . 97



xlO'12/L



4 . 40



- 5.80





MCV



86.9



fL



80



- 99





MCH



31.2



pg



26.0



- 33.5





MCHC (g/L)



* 359



g/L



300 - 350





P.DW



13.0





11.5



- 15.0



White Blood Cells















WHITE CELL COUNT



* 13.77



xic -9/L



3.0



- 10.0





Neutrophils



* 7.60



xlOS9/L



2.0



- 7.5





Lymphocytes



* 4.94



xl0"9/L



1 .2



- 3.65





Monocytes



* 1.01



xlC"9/L



0.2



- 1.0





EosinophiIs



0.18



xl0"9/L



0.0



- 0.4





Basophils



0.C4



xlC~9/L



0.0



- 0.1





BLOCO FILM REPOFT



Lymphocytosis



with occasional



Atypical







lymphocytes seen.







Clotting Cells















FLATELET COUNT



191



xl0A9/L



150



- 400



Inflammation Marker













ESP



* 31



mm/ht



1



- 20












Note ref range raised in patients over 40





We recommend that you discuss these results with your doctor.

This is the best I can do with a scanning mouse.

Customer: replied 3 years ago.

COMPLETE BLOOD COUNT

1™.............

I

Test

Result

Units

Rai

ige

HAEMATOIOGY PROFILE

Red Blood Cells

HAEMOGLOBIN (g/L)

15S c

g/L

130

- 170

HCT

0.432

0.37

-0.50

P.ED CELL COUNT

4 . 97

xlO'12/L

4 . 40

- 5.80

MCV

86.9

fL

80

- 99

MCH

31.2

pg

26.0

- 33.5

MCHC (g/L)

* 359

g/L

300 - 350

P.DW

13.0

11.5

- 15.0

White Blood Cells

WHITE CELL COUNT

* 13.77

xic -9/L

3.0

- 10.0

Neutrophils

* 7.60

xlOS9/L

2.0

- 7.5

Lymphocytes

* 4.94

xl0"9/L

1 .2

- 3.65

Monocytes

* 1.01

xlC"9/L

0.2

- 1.0

EosinophiIs

0.18

xl0"9/L

0.0

- 0.4

Basophils

0.C4

xlC~9/L

0.0

- 0.1

BLOCO FILM REPOFT

Lymphocytosis

with occasional

Atypical

lymphocytes seen.

Clotting Cells

FLATELET COUNT

191

xl0A9/L

150

- 400

Inflammation Marker

ESP

* 31

mm/ht

1

- 20

Note ref range raised in patients over 40


We recommend that you discuss these results with your doctor.

This is the best I can do with a scanning mouse. pdfs are much clearer

Expert:  Dr. SH replied 3 years ago.
Hi there.
Thank you for your question.
I will be helping you out with your queries.
Welcome.
I am Dr. Shahzad and will be helping you out with your concerns.
Can you please let me know if 'lymphocytosis' is your main concern?
Have you had any hormonal tests done like thyroid, cortisol etc?
Please let me know
Customer: replied 3 years ago.

Thyroid tests all okay. Cortisol I understand is okay.

I do not know what Lymphocytosis is. Nor do I understand the technical details of the blood tests. Can you explain each of them?

Also would the drug terbinafine alter them to such a high degree. It is taken for athletes foot.

Expert:  Dr. SH replied 3 years ago.
Do you have any other medical problems?
Are you on any medications for anything else currently?
Please let me know.
Customer: replied 3 years ago.

Only terbinafine a drug to clear up a toenail infected with athletes foot.

The symptoms were there since infancy and as far as I know it was Measles/Rubella at the age of 18 months caused it or I dragged it from my mother at birth. Surely thos blood tests mean something.

Expert:  Dr. SH replied 3 years ago.

Thank you for the additional information.

One thing that is very clear from the complete blood count report is that you definitely have lymphocytosis.

Before going into details on what's the cause of your lymphocytosis I would like to mention that a complete blood count is a test that is done routinely in the vast majority of patients who visit the doctor's office.

So this is not a special or specific test, it is a routine test.

The other thing that I can see mentioned in your history is that your doctor mentioned that you had a complete blood count three years back which did not show lymphocytosis.

Lymphocytosis is mentioned as a side effect of terbinafine so that may be the cause.

Another cause pertinent to your case may be a chronic infection i.e. chronic athlete's foot.

Any chronic infection can cause one to have lymphocytosis.

The bot***** *****ne is that I would not worry too much about the raised lymphocyte count as it may either indicate a chronic infection or possibly a side effect of the medication that you are on.

In either case it is not something dangerous, or life threatening or anything to worry about.

Lymphocytosis is not an indication for stopping the drug i.e. terbinafine. So you should complete the course.

I would repeat the complete blood count once your infection has settled completely i.e. about a month or two later.

Let me know if you have more questions.

Rate me positively for my services when you are done asking.

Kindest Regards

Expert:  Dr. SH replied 3 years ago.
I would appreciate it if you rate me for my services before you leave.
Its only when you rate me that I am paid here on this site.
Thank you.
Dr. SH, Board Certified Physician
Category: Medical
Satisfied Customers: 8796
Experience: Doctor of Medicine
Dr. SH and other Medical Specialists are ready to help you
Customer: replied 3 years ago.

I do not understand but will have a think and come back some time later.

Do you know

Expert:  Dr. SH replied 3 years ago.
Ok, sure, I will be here for you whenever you come back.
Take care
Goodbye for now :)