Posts by vividcrane24

Maria Fisher46 said:👍

If you rule out all other potential causes, seeing neutropenia pop up alongside an autoimmune condition like Hashimoto thyroiditis is actually quite predictable.

The endocrinologist you mentioned seems to be flatly contradicting both real-world clinical experience and established scientific literature, such as this: https://pubmed.ncbi.nlm.nih.gov/26061308/

Given that we are looking at a mild case of neutropenia—one that hasn't actually increased susceptibility to infections—if it is indeed linked to the autoimmune thyroid disease, there is no need for treatment.

Hi everyone,

I just got my swab results back; Chlamydia Mycoplasma/Ureaplasma came back negative, but they did find Streptococcus agalactiae (BHS-B) present in both the mycological and bacteriological tests. View on imgur
Does this shed any light on the symptoms I’ve been describing?
I have an appointment scheduled with a urologist next week regardless...

Maria Fisher46 said:Dear lady,

I am honestly not convinced that an Enterococcus faecalis count of 10^3 CFU/ml is actually linked to the symptoms you are describing.

Furthermore, I don't believe your urinary issues are directly tied to that mild neutropenia you mentioned.

Unless something else turns up in your other microbiology results—you mentioned swabs earlier, right?—I would suggest seeing a gynecologist and a urologist. There are even specialists in urogynecology, so I’d recommend starting your investigation there.

To be blunt, I highly doubt that just one course of an antibiotic from a sensitivity list for E. faecalis is going to magically resolve chronic issues that have been plaguing you for years.

You make a fair point; since my Pap smear came back clean, cervical swabs seem to be the only thing left to check. I have managed to secure appointments for further hematological and urological follow-ups, so I am hoping to get some actual answers regarding these persistent symptoms relatively soon.

While I wait, I am curious about how neutropenia is typically managed when it's triggered by Hashimoto (assuming all other possibilities are ruled out)?
It strikes me as quite odd that one endocrinology specialist told me he wouldn't link elevated lymphocyte counts and low neutrophils to thyroid dysfunction.
On the other hand, isn't there research suggesting that a decreased white blood cell count is frequently observed in patients dealing with autoimmune conditions, such as chronic thyroiditis, and that this possibility might even extend to those with untreated hypertension?

Maria Fisher46 said:Based on what you've shared, it looks like this neutropenia has been hanging around for quite some time—years, actually—and it seems likely to coincide with the diagnosis of an autoimmune thyroid condition. In this light, there’s a lower probability that there's something more sinister driving this neutropenia (though we can't rule it out entirely), and it's entirely possible, just as you suspected, that the two issues are linked via the autoimmune thyroid disease; this isn't exactly uncommon in clinical practice, particularly when dealing with milder cases of neutropenia where no other symptoms of a different underlying illness are present. Regardless, I believe a full workup for the neutropenia should be conducted.

I find it highly unlikely that EBV would be the culprit behind neutropenia that persists for years on end.

As long as the patient remains euthyroid, starting replacement therapy with levothyroxine is not indicated.

Dear Doctor,

I just received my urine culture results, and they show a clear presence of "Enterococcus faecalis".

View on imgur

Could you please interpret this and advise on how I should approach treatment for the chronic, frequent urge to urinate accompanied by a sensation of inflammation or pressure in my lower abdomen and pelvic region (which I mentioned in previous posts)? To reiterate, I was previously prescribed Ninur or Nolicin following a diagnosis of cystitis, but unfortunately, the treatment didn't provide any relief.
Is it possible that the neutropenia could be somehow connected to these urinary issues?
I would appreciate your perspective on this...

Maria Fisher46 said:Dear lady,

If this neutropenia has been lingering for quite some time—and please, don't just give me percentages, I need the actual absolute neutrophil count along with specific dates, because those percentages you mentioned aren't particularly helpful—you really need a full workup.

Are you currently on any medications? Are you experiencing any symptoms? Is there anyone else in your family history dealing with neutropenia?

It would be prudent to undergo a comprehensive evaluation (specifically checking the lymph nodes, liver, and spleen), a peripheral blood smear, ESR, CRP, biochemistry, B12 and folic acid levels, ANA, ENA, RF, serum protein electrophoresis, antineutrophil antibodies, peripheral blood lymphocyte immunophenotyping, and HIV serology; once you have those results, you should consult a hematologist to decide on the next steps. Depending on what the clinical exam and your history show, we might also consider repeating your CBC two or three times a week over the next six to eight weeks.

The diagnostic approach suggested is correct.

Sir,

My apologies for being imprecise regarding the most critical details.
These low neutrophil granulocyte counts aren't exactly a recent development:

rel % (44 - 72) from the results I have in front of me right now:
02/22 - 28.9
2018 - 40.4
2014 - 37.0

10*9/L (2.06 - 6.49)
2/2022 - 1.40
2018 - 1.90

There is no history of neutropenia in my family, and as for how I've been feeling—fatigue, anxiety, bloating, constipation, irregular cycles—it all seems to align with my Hashimoto and PCOS. Regarding medication, I've been taking Emaner and normabel pp over the years, plus I recently started Gynositol per my gynecologist's advice.
While everything is still speculative and pending a complete investigation, I am wondering if this neutropenia could be linked to Hashimoto, especially if we factor in the EBV virus as a potential trigger? I've been reading that prolonged neutropenia (and certain viral infections) can sometimes be tied to the Epstein-Barr virus, which has been considered one of the culprits behind chronic thyroiditis.
On a side note, I'm curious about your take on starting hormone replacement therapy for thyroiditis to manage symptoms, even when the TSH levels appear perfectly normal?

Thank you for the response; I will certainly have to insist on getting these tests done.

Greetings,

I am seeking some insight regarding my elevated lymphocyte counts and decreased
neutrophil granulocytes, specifically concerning what follow-up testing might be necessary.

I was diagnosed with Hashimoto’s thyroiditis about ten years ago.
I haven't started medication because my TSH levels have remained within the normal range thus far.
I am wondering if this condition could potentially trigger these specific drops:
neutrophil granulocytes
current results: 28.9 rel % (44-72); over the last few years, they were 37.0 and 40.4
1.40 10*9/L (2.06 - 6.49); previously, it was 1.90
alongside high lymphocyte counts—55.5 rel % (20 - 46); previously, it was 50.0

My doctor didn't explicitly draw a connection between the two, though he did make a passing comment about neutropenia and its potential causes.
Additionally, he sent me for a urine culture due to a persistent, recurring urge to urinate that I still can't quite account for; in the past, I was even seen by Ninur Nolicin because of elevated white blood cell counts in my urine (ranging from 10-15, 10-12, to 12-17).
My father noted everything seemed fine from a gynecological standpoint, yet now my doctor is sending me back for more exams and swabs since they weren't performed previously.