Anisocytosis on CBC?!

[Bmom]

A quick backstory - I went to the ER several weeks back because I had what I thought was a bad panic attack, but then I started doubting that’s what it really was after it persisted for a week. Dizziness, disorientation, breathlessness, chest pain, internal shaking, feeling of constant adrenaline flooding my body. ALL bloodwork and EKG were normal at the ER and they said anxiety. I started taking klonopin at night again and the symptoms became minimal.

Then last week I went to follow up with my family doctor who ran bloodwork again and I wasn’t really nervous about it this time seeing as how I just had a normal CBC a few weeks ago. Well I got my bloodwork back and even though EVERYTHING is within normal limits, on the hematologist’s review it said “anisocytosis present.”

Of course I googled and freaked myself completely out as it can range from anything from iron and B12 anemia to pre-leukemia?!?!?! It basically means my red blood cells are of varied sizes. My MCV is 95 (normal is 79-97) so it is on the upper end. My bloodwork doesn’t fit the anemic profile. :(

Oh my goodness, we are leaving for the beach tomorrow and I can’t even concentrate and get excited because I’m so panicky about this!!! I’m a teacher and should be looking forward to school being out tomorrow but I’m in such an anxious state. :(

If anyone has any medical background that could comment, because I truly am not going to let myself google anymore. My doctor said she’s not worried about it “at this time.” But that we will recheck in a few weeks to see if it has persisted.😩😩😩😩 I cant wait a few weeks like this!!!! HELP!!!

---------- Post added at 09:28 ---------- Previous post was at 06:28 ----------

Anyone have any experience with this?????

[ToasterOvens]

You're probably not going to have anyone with a medical background post.

I definitely don't have a medical background, but I went to a hematologist for a while because I had like half my parameters on the CBC off. Within a month they all went back to normal. Wasn't sick. Nothing obvious happened. They all just went normal. That was two years ago and the hematologist diagnosed me as perfectly healthy.

You even had a normal CBC prior. Getting a follow up is normal protocol, doesn't mean you have a health condition.

I personally feel as though you have nothing to worry about.

[Bmom]

Thank you so much for your kind reply - it doesn’t have to be someone with medical experience, maybe just someone who has had some sort of experience with something similar. I’m really trying to talk myself down today and enjoy the day but it’s been extremely hard :(

[tan235]

if you had a complete CBC the week before and now thats come up on another blood test the week later than it's incidental and probably nothing but an anomaly. I"m not a professional either but I do know that blood tests can change of course due to what you ate etc and your dr will probably say not enough numbers for it to be an issue. I wouldn't worry about it and I worry a bout EVERYTHING!

---------- Post added at 01:24 ---------- Previous post was at 01:22 ----------

I had a blood test and then a week later another one, it came back as high postassium =- really high, the Dr ordered another one and it was fine, she said sometimes when they take the test it can affect the result if they put in the needle to hard etc .... so don't worry.

[Bmom]

Thank you for your reply. It helped me for a couple of days and I’ve kept re-reading it, but I’m starting to really get into a spiral again. I’m really short of breath, probably hyperventilating. I can’t stop thinking this is pre-leukemia or something terrible. I’m trying so hard to work through this but can’t seem to. I just want to enjoy my family and not want this stupid abnormality on these last labs. 😩

[ToasterOvens]

Is the value even outside the range by much? If my WBC count was 10.1, but the range was like 4-10... it would still be Leukocytosis. But probably zero doctors would even care.

When I went to the hematologist, I was specifically tested for pre-leukemia. Half of my parameters were off, and the hematologist told me that he didn't think I had leukemia or pre-leukemia.

[Bmom]

None of my values were outside the parameters besides my eosinophils by like .1. That happened last year but she said it was purely allergies and after being re-tested it went away.

But NONE of my Other values were off. Here are my results:

CBC+PLATELET+HEM REVIEW-320887-U 05/21/2018 (#455015, Final, 05/15/2018 11:15am)
Note to Patient we will discuss these with you at next appt
Report Result Ref. Range Units Status Lab
WBC 7.0 3.4-10.8 x10E3/uL Final 01
RBC 4.76 3.77-5.28 x10E6/uL Final 01
HEMOGLOBIN 14.5 11.1-15.9 g/dL Final 01
HEMATOCRIT 45.1 34.0-46.6 % Final 01
MCV 95 79-97 fL Final 01
MCH 30.5 26.6-33.0 pg Final 01
MCHC 32.2 31.5-35.7 g/dL Final 01
RDW 12.7 12.3-15.4 % Final 01
PLATELETS 292 150-379 x10E3/uL Final 01
NEUTROPHILS 50 NOT ESTAB. % Final 01
LYMPHS 30 NOT ESTAB. % Final 01
MONOCYTES 12 NOT ESTAB. % Final 01
EOS 7 NOT ESTAB. % Final 01
BASOS 1 NOT ESTAB. % Final 01
IMMATURE CELLS NP Cancelled 01
NEUTROPHILS ABSOLUTE 3.5 1.4-7.0 x10E3/uL Final 01
LYMPHS (ABSOLUTE) 2.1 0.7-3.1 x10E3/uL Final 01
MONOCYTES(ABSOLUTE) 0.8 0.1-0.9 x10E3/uL Final 01
EOS (ABSOLUTE VALUE) 0.5 0.0-0.4 x10E3/uL Above High Normal Final 01
BASO(ABSOLUTE) 0.1 0.0-0.2 x10E3/uL Final 01
NRBC NP Cancelled 01
DIFFERENTIAL COMMENT NP Cancelled 01
RBC COMMENT Anisocytosis present. NORMAL Final 01
PLATELET COMMENT Adequate ADEQUATE Final 01
RESULT NOTE FASTING YES

[Fishmanpa]

I'm not a doctor but the only thing I see is

EOS (ABSOLUTE VALUE)0.5 0.0-0.4 x10E3/uL Above High Normal Final .01

One thing .01 above normal :shrug: That's absolutely NOTHING! Everything else... everything... is NORMAL!

Worry if you want :shrug: The "Told ya so Gang" will be on standby.

Positive thoughts

[Bmom]

Thank you fishmanpa!

Do you see where it says “anisocytosis present normal”???

If it’s normal why would they even put that?! And if I hav normal values, how is anisocytosis present???🤷🏼*♀️🤷🏼*♀️🤷🏼*♀️😩

I did notice my monocytes are higher than they’ve ever been as well and I wasn’t sick when I had labs drawn.

[Shadowhawk]

Thank you fishmanpa!

Do you see where it says “anisocytosis present normal”???

If it’s normal why would they even put that?! And if I hav normal values, how is anisocytosis present???🤷🏼*♀️🤷🏼*♀️🤷🏼*♀️😩

I did notice my monocytes are higher than they’ve ever been as well and I wasn’t sick when I had labs drawn.




You are misreading the results - when doing the test, they were asked to look for anisocytosis- the comment is saying the check came back normal, not that it was present and normal. Basically, think of the "anisocytosis present" as another line item on the list (like WBC, RBC), and the result is normal (if you had it, it would say abnormal).



Nothing about that blood work should cause anyone to bat an eye - your levels are in range. Something to keep in mind with the ranges - they are set for the "common" healthy person. People can have values outside a range and have it be normal and healthy for them. All lab results must be interpreted in the context of the patients overall health.

[Bmom]

That would be SO reassuring but my doctor even said that she was not worried about it “for now” and that we would recheck to make sure it hasn’t persisted. So that leads me to believe that it WAS present and that she will recheck because of that??

Her message back to me was “It means that your red blood cell size is variable. Your hemoglobin, hematocrit, and platelet count were all within range. i think the red blood cell variant is ok and i dont see any need for worry at this time but we can check it again when you come in to make sure this hasnt persisted. see you soon!”

So I do think it is present. I just wish my brain could let this go! I’m sorry, I know I’m being the worst right now!!!

[Fishmanpa]

That would be SO reassuring but my doctor even said that she was not worried about it “for now” and that we would recheck to make sure it hasn’t persisted. So that leads me to believe that it WAS present and that she will recheck because of that??

Her message back to me was “It means that your red blood cell size is variable. Your hemoglobin, hematocrit, and platelet count were all within range. i think the red blood cell variant is ok and i dont see any need for worry at this time but we can check it again when you come in to make sure this hasnt persisted. see you soon!”

So I do think it is present. I just wish my brain could let this go! I’m sorry, I know I’m being the worst right now!!!

It's true, it is present by ".01"! The HA brain will find a way to worry about this and you'll probably hang on to this for your anxiety's dear life but the reality is your doctor isn't concerned. Of course they'll check the next time as it's part of the test and he knows you have anxiety. Anyway... I personally wouldn't even bat an eyelash at this. I have heart disease and you should see my readings! 99% of the people here would be in meltdown mode with my readings ~lol~ BUT... for me and my condition, my doctors aren't concerned nor am I :shrug:

Positive thoughts

[Bmom]

Thank you! I’m not worried about the .01 eosinophils because that has happened before but I AM worried and having this tailspin over the “ANISOCYTOSIS PRESENT” because I broke the HA rule and googled as soon as I got the results last week. :(

[Fishmanpa]

Thank you! I’m not worried about the .01 eosinophils because that has happened before but I AM worried and having this tailspin over the “ANISOCYTOSIS PRESENT” because I broke the HA rule and googled as soon as I got the results last week. :(

Then if you googled, you know the most common cause is low iron :whistles:

But of course your HA latched onto the most sinister reason :doh:

Anyway.......

Positive thoughts

[Bmom]

I know! But my hemoglobin is normal, so that’s when I start questioning. If I can rationalize the results then it doesn’t worry me, but if nothing matches up, that’s when I go down the sinister road. I know, it’s pitiful. It’s HA. I so dearly appreciate all of your replies and your time!

[ToasterOvens]

I truly think you have nothing to worry about.

I'm a bit confused though about that comment, since I'm pretty sure RDW is the measure of how differently sized your red blood cells are (Anisocytosis). And your RDW was in range.

AGAIN not a doctor, but I researched my results way too much.

If I posted my results on here like you posted yours, you'd be amazed how "off" a test could be and someone still be perfectly healthy. Just do what your doctor says and trust them. Your doctor doesn't sound worried at all tbh.

[Shadowhawk]

I truly think you have nothing to worry about.

I'm a bit confused though about that comment, since I'm pretty sure RDW is the measure of how differently sized your red blood cells are (Anisocytosis). And your RDW was in range.

AGAIN not a doctor, but I researched my results way too much.

If I posted my results on here like you posted yours, you'd be amazed how "off" a test could be and someone still be perfectly healthy. Just do what your doctor says and trust them. Your doctor doesn't sound worried at all tbh.


That was my understanding as well, which is why i was reading the "normal" marking as the actual result, and the test was to see if it was present.



RDW is the measure of the size variation in cells. By the medial definition, Anisocytosis is determined by a high RDW:
"RDW is elevated in accordance with variation in red cell size (anisocytosis), ie, when elevated RDW is reported on complete blood count, marked anisocytosis (increased variation in red cell size) is expected on peripheral blood smear review."


I cant see how you could have it with a RDW not even near the upper end of normal.

[Bmom]

Thank you!!! Those were exactly my thoughts as well - it doesn’t make sense to me. Perhaps they did a different type of blood test this time and tested specifically for anisocytosis because I have never had labwork even mention aniscystosis and to be honest, looking back at old labwork through the years, my values are all around the same as years ago!🤷🏼*♀️🤷🏼*♀️🤷🏼*♀️