Can Hashimoto's increase lymphocytes after hysterectomy?

Question

Hi doctor,

I had a total thyroidectomy (TT) two years ago, and on my pathology report of the thyroid, I have had mild thyroiditis, and I have always had high lymphocytes. For one period of about a year, they were raising money every month. My TG and Abt are within normal range. I did anti-TPO, and my result is 2.01, and the reference range is less than 5.6. My question for you is, in my case, can Hashimoto thyroiditis decrease neutrophilia and increase lymphocytes even after hysterectomy? Or shall I consider blood cancer and make the test to rule it out? I do not have any symptoms.

Answer 1

Hi,

Welcome to icliniq.com.

I have reviewed your results (attachment removed to protect patient identity). From what I have seen, leukocytes are within the normal range, as well as hemoglobin; platelets were not reported. From the automatic differential, there is indeed a slight lymphocytosis, but the manual differential (the one reviewed by the doctor under a microscope) reports 70 % neutrophils and 30 % lymphocytes. A mere laboratory result does not hold much strength, especially in your case, when the total leukocyte count is normal, and you report no other complaints such as malaise, night sweats, and/or fever. However, if you have a concomitant enlarged lymph node and/or spleen, proceed with more specific tests such as flow cytometry to rule out chronic lymphocytic leukemia. But, anyway, the manual differential would have shown the presence of atypical, abnormal cells. Since it reports no atypia, this means that it is much less likely that there is a blood disorder (provided that no lymph nodes and spleen are enlarged and you have no complaints). I would suggest a regular, monthly blood count and differential tests, and an abdominal sonography to check for the spleen. The changes in the blood counts can be just a reaction to some conditions. This could be an autoimmune disorder, such as thyroiditis, or a viral infection.

Answer 2

Hi,

Welcome back to icliniq.com.

I would rather say that your problems might be due to thyroiditis and a reflection of a general autoimmune reactivity of your body. I would suggest that you have a check every six months of TSH, anti-thyroglobulin, and anti-TPO antibodies, as well as a complete blood count. One autoimmune disorder usually goes with another. Meaning, if you might have Hashimoto's thyroiditis, there is a high chance that you might develop pernicious anemia, which is an autoimmune-related gastritis, causing anemia. Therefore, a gastroscopy is more relevant in your case, as well as an abdominal ultrasound.