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Posted by on May 11, 2013 in The Tests |

Complete Blood Count

Complete Blood Count

Curious about your CBC test results? Need some advice interpreting the numbers? Head for the forums in Full Blood Count Results to discuss!

The complete blood count is a good indicator of how well the bone marrow is working. A normal full blood count usually means that if there are mast cells in the bone marrow, they are scanty or not present in enough numbers to affect the bone marrow function.

A complete blood count (CBC) test measures the following:

  • The number of red blood cells (RBC count)
  • The number of white blood cells (WBC count)
  • The total amount of hemoglobin in the blood
  • The fraction of the blood composed of red blood cells (hematocrit)

The CBC test also provides information about the following measurements:

  • Average red blood cell size (MCV)
  • Hemoglobin amount per red blood cell (MCH)
  • The amount of hemoglobin relative to the size of the cell (hemoglobin concentration) per red blood cell (MCHC)
  • The platelet count is also usually included in the CBC.

How the Test is Performed

A blood sample is needed. For information on how this is done, see: Venipuncture

How to Prepare for the Test

There is no special preparation needed.

How the Test Will Feel

When the needle is inserted to draw blood, you may feel moderate pain, though most people feel only a prick or a stinging sensation. Afterward there may be some throbbing or bruising.

Why the Test is Performed

A complete blood count (CBC) is used to detect or monitor many different health conditions. It may be used to:

  • Diagnose infections or allergies
  • Detect blood clotting problems or blood disorders, including anemia
  • Evaluate red blood cell production or destruction

Normal Results

Blood counts may vary with altitude. In general, normal results are:

RBC count:

  • Male: 4.7 to 6.1 million cells/mcL
  • Female: 4.2 to 5.4 million cells/mcL

WBC count:

  • 4,500 to 10,000 cells/mcL

Hematocrit:

  • Male: 40.7 to 50.3%
  • Female: 36.1 to 44.3%

Hemoglobin:

  • Male: 13.8 to 17.2 gm/dL
  • Female: 12.1 to 15.1 gm/dL

Red blood cell indices:

  • MCV: 80 to 95 femtoliter
  • MCH: 27 to 31 pg/cell
  • MCHC: 32 to 36 gm/dL

Note:

  • cells/mcL = cells per microliter
  • gm/dL = grams per deciliter;
  • pg/cell = picograms per cell

The examples above are common measurements for results of these tests. Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your doctor about the meaning of your specific test results.

What Abnormal Results Mean

A high RBC or hematocrit may be due to:

  • Dehydration (such as from severe diarrhea)
  • Kidney disease with high erythropoietin production
  • Low oxygen level in the blood for a long time due to heart or lung disease
  • Polycythemia vera
  • Smoking

A low RBC or hematacrit is a sign of anemia, which can result from:

  • Autoimmune diseases such as lupus erythematosus or rheumatoid arthritis
  • Blood loss (hemorrhage)
  • Bone marrow failure (for example, from radiation, infection, or tumor)
  • Chronic kidney disease
  • Hemolysis (red blood cell destruction)
  • Leukemia and other blood cancers
  • Long-term infections such as hepatitis
  • Poor diet and nutrition, causing too little iron, folate, vitamin B12, or vitamin B6
  • Multiple myeloma

A lower than normal white blood cell count is called leukopenia. A decreased WBC count may be due to:

  • Autoimmune diseases (such as systemic lupus erythematosus)
  • Bone marrow failure (for example, due to infection, tumor, radiation, or fibrosis)
  • Disease of the liver or spleen

High numbers of WBCs is called leukocytosis. It can result from:

  • Infectious diseases
  • Inflammatory disease (such as rheumatoid arthritis or allergy)
  • Leukemia
  • Severe emotional or physical stress
  • Tissue damage (such as burns)

Low hemoglobin values may be due to:

  • Anemia (various types)
  • Blood loss

Risks

There is very little risk involved with having your blood taken. Veins and arteries vary in size from one patient to another and from one side of the body to the other. Taking blood from some people may be more difficult than from others.

Other risks associated with having blood drawn are slight but may include:

  • Excessive bleeding
  • Fainting or feeling light-headed
  • Hematoma (blood accumulating under the skin)
  • Infection (a slight risk any time the skin is broken)

Considerations

RBCs transport hemoglobin which, in turn, carries oxygen. The amount of oxygen received by body tissues depends on the amount and function of RBCs and hemoglobin.

WBCs are mediators of inflammation and the immune response. There are various types of WBCs that normally appear in the blood:

  • Neutrophils (polymorphonuclear leukocytes)
  • Band cells (slightly immature neutrophils)
  • T-type lymphocytes (T cells)
  • B-type lymphocytes (B cells)
  • Monocytes
  • Eosinophils
  • Basophils

Alternative Names

Full blood count, CBC

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Posted by on May 11, 2013 in The Tests |

Serum Tryptase

Serum Tryptase

Curious about your Serum Tryptase test results? Need some advice interpreting the numbers? Head for the forums in Full Blood Count Results to discuss!

Tryptase is one of the hundreds of mediators released by the mast cells when they have been triggered to degranulate for any reason.

Tryptase is a protease, or an enzyme that helps break down proteins, that is often elevated during an allergic reaction. According to Dr. Glenn Reeves of the Hunter Area Pathology Service, tryptase is seen only in mast cells. During an anaphylactic reaction, your levels of serum tryptase elevate within an hour and stay this way for four to six hours. Certain foods and food additives can cause an allergic reaction and result in raised blood levels of tryptase

Blood tryptase levels are thought to reflect the quantity of mast cells that may be in the body and a level of greater than 20ng/ml is currently believed to be the level to suggest that the bone marrow has been infiltrated by mast cells. As tryptase levels can rise after anaphylaxis, it is therefore important that the tryptase level is measured when the patient is at his/her baseline level of health and not during or soon after an anaphylactic reaction. It is important to remember a tryptase level of greater than 20ng/ml alone does not lead to a diagnosis of systemic mastocytosis.

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Posted by on May 11, 2013 in The Tests |

Abdominal Ultra Sound Scan

Abdominal Ultra Sound Scan

 

Please help other site viewers and share your experience on your ultra sound scan in the forum here.

What Is An Ultrasound Scan?

An ultra sound scan is a simple test carried out to document the size of the spleen and liver. Some patients can develop an enlarged spleen, as mast cells can increase in numbers in the spleen as well as other organs. Sometimes this enlargement can be felt during an examination of the abdomen, but this is unusual.

Is It Safe?

An ultrasound scan, sometimes called a sonogram, is a procedure that uses high frequency sound waves to create an image of part of the inside of the body, such as the heart. As sound waves are used rather than radiation, the procedure is safe. Ultrasound scans are commonly used during pregnancy to produce images of the baby in the womb.

What Happens During An Ultrasound Scan?

Most ultrasound scans don’t take long to perform, typically between 15 and 45 minutes. Your ultrasound scan will generally take place in an X-ray department in hospital and be performed either by a doctor, who will provide a diagnostic report, or by a sonographer. A sonographer is a specialist trained in the use of ultrasound, who will provide a descriptive report for the doctor to make a diagnosis.

An external ultrasound scan is the type of scan most often used to examine your heart or an unborn baby in your womb, so it is very likely you have already seen the procedure in movies.

A small handheld device called a transducer is placed onto your skin, and moved over the part of the body being examined.

A lubricating gel is put onto your skin. The gel allows the transducer to move smoothly ensuring there is continuous contact between the sensor and the skin. The transducer is connected to a computer and a monitor. Pulses of ultrasound are sent from a probe in the transducer, through your skin and into your body. They then bounce back from the structures of your body to be displayed as an image on the monitor.

As well as producing still pictures, an ultrasound scan shows movement that can be recorded onto video.

You should not feel anything other than the sensor and gel on your skin (which is often cold).

At the end of the procedure, you will be handed tissues to remove the excess gel from your skin. You may feel a bit sticky afterwards, but it is nothing that a shower wouldn't resolve.

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Here is a short (2:40) video clip, outlining the procedure:

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Posted by on May 11, 2013 in The Tests |

Bone Density (DEXA) Scan

Bone Density (DEXA) Scan

 

Do you want to share your experience or the results of your DEXA scan? Head for the DEXA Scan forum and compare your z-scores and all!

What Is A DEXA Scan?

DEXA stands for dual energy X-ray absorptiometry.

A DEXA scan is a quick and painless procedure that involves lying on your back on an X-ray table so that an area of your body can be scanned.

No preparations are needed before you have a DEXA scan. Depending on the part of your body being scanned, you may be able to remain fully clothed. However, you will need to remove any clothes that have metal fastenings. In some cases, it may be necessary for you to wear a gown.

Why Do I Need A DEXA Scan?

A DEXA Scan (also known as DXA scan) is a special type of x-ray which looks to see if there is any evidence of osteoporosis (where the bones are thinning, become weak and fragile and more likely to break). This thinning can sometimes be caused by accumulation of mast cells.

Osteoporosis can affect people of both sexes and all ages, although older, post-menopausal women are particularly at risk. This is because after the menopause the level of the hormone oestrogen falls, resulting in a decrease in bone density.

The denser your bones, the stronger and less likely they are to fracture (break). Osteoporosis does not cause any symptoms until a bone is broken.

In the past it was difficult to measure bone density and identify those at risk of developing osteoporosis, until a fracture occurred. However, by using bone densitometry techniques, such as bone density scans, it is now possible to measure bone density before fractures occur.

The scan is used as a baseline and, if there is evidence of osteoporosis, medication can be started to try and slow the speed at which it develops or reverse it.

A DEXA bone scan can also help detect other bone-related conditions, such as osteopenia (very low bone mineral density) and osteomalacia (softening of the bones caused by a vitamin D deficiency).

Measuring Bone Density

During a DEXA scan, X-rays will be passed through your body. Some radiation will be absorbed by the bone and soft tissue, and some will travel through your body. Special detectors in the DEXA scanner measure how much radiation passes through your bones and this information is sent to a computer. The measurements will be compared to the normal range for bone density in a healthy adult and someone of the same gender and ethnicity.

Unlike a magnetic resonance imaging (MRI) scan, a DEXA scan does not involve being enclosed inside a tunnel, so you will not feel claustrophobic.
Instead, you lie on your back on a flat X-ray table. You will need to keep very still during the scan so that the images produced are not blurred.

The scan will usually be carried out by a radiographer (a specialist in taking X-ray images). As the scanning arm is slowly moved over your body, a narrow beam of low-dose X-rays will be passed through the part of your body being examined. This will usually be your hip and lower spine to check for osteoporosis. However, as bone density varies in different parts of the skeleton, more than one part of your body may be scanned.

Some of the X-rays that are passed through your body will be absorbed by tissue, such as fat and bone. An X-ray detector contained in the scanning arm will measure the amount of X-rays that have passed through your body. This information will then be used to produce an image of the scanned area.

A DEXA scan usually takes five minutes or less, depending on the area of your body being examined and whether you are having a central or peripheral scan. During a peripheral scan, a small, portable device will be used to scan an area of your body such as your forearm, heel or hand.

You will be able to go home immediately after having a scan.

Your Results

A DEXA scan compares your bone density with the bone density of a young healthy adult or an adult of your own age, gender and ethnicity. The difference is then calculated as a standard deviation (SD), which is a measure of variability based on an average or expected value.

The difference between your measurement and that of a young healthy adult is known as a T score, and the difference between your measurement and that of someone of the same age is known as a Z score.

The World Health Organization (WHO) classifies T scores as follows:

  • Above -1 SD is normal
  • Between -1 and -2.5 SD is classed as osteopenia
  • Below -2.5 SD is classed as osteoporosis

If your Z score is below -2, your bone density is lower than it should be for someone your age.

Although bone mineral density (BMD) readings provide a good indication of bone strength, the results of a DEXA scan will not necessarily predict whether a fracture is likely to occur.

For example, someone with low bone density may never break a bone, whereas someone with average bone density may have several fractures. This is because other factors, such as age, sex or previously having had a fall, will also determine your susceptibility to experiencing a fracture. Therefore, your doctor will consider all of your individual risk factors before deciding whether treatment is necessary.

Safety

A DEXA scan is a quick and painless bone scan and is more effective than a normal X-ray in identifying low bone density. It also uses a much lower level of radiation than a standard X-ray.

A DEXA scan uses the equivalent of less than 10% of one day’s exposure to natural background radiation. By comparison, a chest X-ray uses the equivalent of about five days' exposure to natural background radiation.

Despite being very safe procedures, DEXA scans and X-rays are not recommended for women who are pregnant. X-rays are not considered to be safe to use during pregnancy because they can cause damage to an unborn child.

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Here's a short video (4:15) of a DEXA scan procedure, with further clarifications.

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Posted by on May 11, 2013 in The Tests |

Bone Marrow Biopsy

Bone Marrow Biopsy

 

Please help other site viewers and share your experience on your bone marrow biopsy in the forum here.

What Is A Bone Marrow Biopsy?

A bone marrow biopsy is the removal of soft tissue, called marrow, from inside bone. Bone marrow is found in the hollow part of most bones. It helps form blood cells.

Why Do I Need A Bone Marrow Biopsy?

A Bone Marrow Biopsy is recommended when the baseline blood tryptase levels are greater than 20ng/ml in adults or there are other reasons for suspecting systemic mastocytosis.

Once consent is obtained from the patient, the procedure is usually carried out as a day case under a local anaesthetic.

The bone marrow histology can give us important information:

  • Firstly, it can confirm the diagnosis of systemic mastocytosis when abnormal numbers or types of mast cells are seen within the bone marrow.
  • Secondly, as bone marrows from many patients are analysed, the collected data over the years has allowed  to differentiate between characteristics of the less aggressive (indolent or benign) mast cells from the more aggressive type of mast cells.

Bone marrow findings cannot be interpreted on their own to classify the type of systemic mastocytosis. The blood count, serum tryptase levels and the presence of any organ damage should be taken into account before making a final diagnostic.

Occasionally, when the bone marrow has been infiltrated by mast cells, it is because there is another underlying blood disorder which itself increases mast cell production as part of a process different from systemic mastocytosis.

How The Test is Performed

A bone marrow biopsy may be done in the health care provider's office or in a hospital. The sample may be taken from the pelvic or breast bone. Sometimes, other areas are used.

The health care provider will clean the skin and inject a numbing medicine into the area. Rarely, you may be given medicine to help you relax.

The doctor inserts the biopsy needle into the bone. The center of the needle is removed and the hollowed needle is moved deeper into the bone. This captures a tiny sample, or core, of bone marrow within the needle. The sample and needle are removed. Pressure and a bandage are applied to the biopsy site.

A bone marrow aspirate may also be performed, usually before the biopsy is taken. After the skin is numbed, the needle is inserted into the bone, and a syringe is used to withdraw the liquid bone marrow. If this is done, the needle will be removed and either repositioned, or another needle may be used for the biopsy.

How to Prepare for the Test

Tell the health care provider:

  • If you are allergic to any medications
  • What medications you are taking
  • If you have bleeding problems
  • If you are pregnant

You must sign a consent form.

How The Test Will Feel

You will feel a sharp sting when the numbing medicine is injected. You may feel a brief, sharp pain when the liquid (aspirate) is removed.

The biopsy needle may also cause a brief, usually more dull, pain. Since the inside of the bone cannot be numbed, this test may cause some discomfort. However, not all patients have such pain.

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Here's a short video of a biopsy. Viewer discretion advised.

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Posted by on May 11, 2013 in The Tests |

Genetic Testing

Genetic Testing

This post is still under construction.

Disregard its content, if any, as it only contains raw reference material for the future post.


Do you have questions or want to share your knowledge of genetics? Head for The Ninja Mutant Mastos (Genetics) forum.

Explain 23andme and possible benefits (and risks)

Codon 816 c-kit mutation (also known as D816V) can be tested for in the bone marrow or any organ involved with large numbers of abnormal mast cells. It is present in about 85% of patients. As there are usually very few mast cells in the blood, in most cases bone marrow samples are needed to give useful results.

This c-kit mutation leads to increased levels of a protein receptor on mast cells called KIT (a tyrosine kinase) which is involved in controlling mast cell growth and causes increased numbers of mast cells in the bone marrow and elsewhere.

Testing for this D816V c-kit mutation is important as new drugs (called tyrosine kinase inhibitors) are being specifically developed to target its function and slow or even stop the production of mast cells. Also, some drugs (for example, one called Glivec) may not be effective in patients who are shown to have this mutation.

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