Hi doctor, I have a question about my mom's peripheral blood smear test. She is 62 years old and is diabetic. The report says she has normocytic normochromic anemia with neutrophilic leukocytosis. Her neutrophils are 85 %, lymphocytes are 14 %, eosinophils are 1 %, and neutrophils show coarse toxic cytoplasmic granules. Her feet are swollen from the past two months, which is the reason we did this test. Please provide insight. What disease does she have? What is the treatment? I have attached her test reports. Thanks.
Hi. I have seen her reports (attachment removed to protect patient identity). In your mom's case, considering that she is a diabetic patient with swelling in both her feet (also known as edema), a few things come to my mind. She could be having some skin infection in the swollen legs. And to fight this infection, the body mounts a response in the form of increased number of neutrophils to fight the infection. I am worried why she has this swelling in the first place. She could be having high blood pressure or hypertension or early signs of heart failure. Diabetes is also known to cause kidney problems that can result in water retention in the body and resultant leg edema. Diabetes and kidney issues, can themselves increase the risk for infection, especially in elderly patients. Renal injury because of diabetes can lead to anemia of the type mentioned in your mom's peripheral blood smear test. It means she has decreased red blood cells production because of one or more of the following: So, here is what needs to be done: For now, see a local practitioner and discuss the above. Do not ignore the swelling. For more information consult a general surgeon online -->