Ongoing Concerns with Elevated Immature Granulocytes
Age: 60 years, Height: 5'10", Weight: 169 lbs, Ethnicity: Caucasian. Issue: For several years, my Complete Blood Count (CBC) has consistently shown elevated Immature Granulocytes. I am a professor of physics at a prominent university in the United States. My medical history includes Type 2 Diabetes (which is well-managed), high cholesterol levels (hypercholesterolemia), panic disorder, seborrheic dermatitis, and mild cognitive impairment. Current Medications: Metformin, Rosuvastatin, Klonopin, Vascepa, Vitamin D3, Nizoral shampoo. Over the past three years, I have been experiencing significant fatigue and breathing difficulties. These symptoms tend to fluctuate, with days of severity followed by some relief. Writing this message is a challenge for me at the moment. Classes are about to resume, and I am uncertain if I will be able to keep up this time. I visited the emergency room on August 16, 2025, and was diagnosed with Diverticulitis, for which I am currently taking Augmentin for ten days. Upon reviewing my bloodwork history, the persistent presence of elevated Immature Granulocytes is a concerning factor. Whenever I discuss this with my primary care physician, she seems dismissive. I often feel that my physical symptoms are misattributed to psychological issues. The latest data point from my IG% levels was recorded during my recent ER visit on August 16, 2025.
Answers (1)
8/18/2025, 6:12:47 PM
OpenHealth AI
I understand that you're dealing with persistent fatigue, difficulty breathing, and elevated immature granulocytes, which can be frustrating and concerning, especially with your upcoming classes. Here’s a clear breakdown of your situation and what you can do next.
Key Points:
- Elevated Immature Granulocytes (IGs): These can indicate ongoing inflammation or a reaction to infection. Elevated IGs may point to a number of conditions, but they are often not a standalone diagnosis.
- Fatigue and Breathing Difficulties: These symptoms can result from various factors, including your underlying conditions, medications, or infections.
- Recent Diverticulitis: Your recent diagnosis and treatment may also be influencing your bloodwork and overall health.
Explanation:
Immature granulocytes can be a response to infection, inflammation, or other stressors on the body. While they aren't specifically a disease marker, their persistent elevation alongside fatigue and breathing issues warrants careful attention. Your diverticulitis and existing health conditions, particularly diabetes and high cholesterol, can also play a role in your overall well-being.
Next Steps:
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Track Symptoms: Keep a daily journal noting when your fatigue and breathing difficulties occur, their severity, and any other symptoms. This can provide valuable information for your healthcare provider.
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Follow-Up with Your Doctor: If you feel your concerns are not being addressed adequately, consider requesting a referral to a specialist (like a hematologist or an infectious disease expert) to explore the significance of your elevated immature granulocytes further.
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Monitor and Manage Chronic Conditions: Ensure your diabetes remains well-managed and stay on top of cholesterol levels with your medications. Good management can help reduce fatigue and associated symptoms.
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Consider a Comprehensive Evaluation: Ask about a complete workup, including tests for infection, inflammation markers, or other potential causes of your fatigue and breathing difficulties.
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Connect with Support: If you feel dismissed, it may be helpful to have a family member or trusted friend accompany you to appointments. They can help communicate your concerns more effectively.
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Self-Care Practices: Maintain a balanced diet, stay hydrated, and incorporate light exercise as tolerated, which can support energy levels. Address any panic disorder symptoms through relaxation techniques or therapy, if not already in place.
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Consider Psychological Health Support: Given your feelings of being misunderstood, talking with a mental health professional may provide additional coping strategies for dealing with stress and fatigue.
It’s important to advocate for yourself in your healthcare journey, and I encourage you to persist in seeking answers regarding your health concerns. Ensuring your voice is heard can lead to more effective management of your symptoms. Please let me know if you need any more specific information about any of these steps!
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - **Portocaval shunt size: 9.9 mm** (blood bypassing the liver into the inferior vena cava) - **Arteriovenous shunt size: 4.4 mm** - **Portal vein size: 6.1 mm** (patent) - **Three nodular cystic lesions** located in the perivascular area, with largest measuring 11.6×20.7 mm, enhancing during the venous phase - Liver features a heterogeneous architecture, exhibiting irregular enhancement - Gallbladder appears elongated and slightly enlarged - Other abdominal organs exhibit normal findings **RADIOLOGIST’S ASSESSMENT:** "Congenital portosystemic shunt indicative of Abernethy malformation; less likely arteriovenous malformation (AVM); cannot dismiss the possibility of localized liver lesions." **ADVICE:** Seek consultations with an abdominal and vascular surgeon. ### Blood Tests (August 1, 2025): **Complete Blood Count:** - WBC: 10.44 × 10⁹/L (normal range) - **RBC: 2.1 × 10¹²/L** (LOW - indicating severe anemia) - **Hemoglobin: 69 g/L** (CRITICALLY LOW; normal is 117-166) - Platelets: 403 × 10⁹/L (elevated) **Biochemistry Analysis:** - 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WBC: 5.8 × 10⁹/L (SHOWS IMPROVEMENT) - **RBC: 2.93 × 10¹²/L** (IMPROVED but still low) - **Hemoglobin: 72 g/L** (SHOWS IMPROVEMENT but still low) - Platelets: 223 × 10⁹/L (BACK TO NORMAL) - Neutrophils: 30.0% - Lymphocytes: 64.8% - Monocytes: 4.6% ### Biochemistry (January 28, 2026): - Total protein level: 67 g/L (slightly deficient) - Creatinine: 20.7 μmol/L - **Total Bilirubin: 242 μmol/L** (STILL HIGH - unchanged) - **Direct Bilirubin: 142 μmol/L** (VERY HIGH) - **ALT: 50 IU/mL** (DRASTICALLY LOWER from >1000!) --- ## OVERVIEW OF PROGRESS OVER 6 MONTHS | Parameter | August 2025 | January 2026 | Change | |------------------|-------------|---------------|--------------------------| | **Hemoglobin** | 69 g/L | 72 g/L | ↗ Slight improvement | | **RBC** | 2.1 | 2.93 | ↗ Improved | | **ALT** | >1000 | 50 | ✓✓ MAJOR IMPROVEMENT | | **Bilirubin** | 245 | 242 | → Unchanged (still elevated) | | **Portal vein** | 6.1 mm | 3.9 mm (US) | ↗ Decreased | | **Platelets** | 403 | 223 | ↘ Normalized | | **Shunt size** | 9.9 mm | 9.9 mm | → No Change | --- ## CURRENT SITUATION (February 2026 - 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Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? 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