Case 150 – the beginning

A 29 year old lady sees her GP due to feeling generally unwell. She thinks she has lost some weight over the last few weeks, and has also had cold type symptoms during that time (sore throat, runny nose, fatigue).

She has asthma for which she takes inhalers, but otherwise is fit and well. She works as a shop assistant and smokes 10 cigarettes daily. She drinks alcohol socially.

On examination she has small but palpable bilateral tender cervical lymph nodes with not much else to comment on. She looks otherwise well.

Her full blood count is as follows:

Hb 135 g/L
Plt 268 x10^9/L
WCC 10.9 x10^9/L
Neutrophils 1.8 x10^9/L
Lymphocytes 4.6 x10^9/L
Monocytes 0.9 x10^9/L
Eosinophils 3.6 x10^9/L
Basophils 0.01 x10^9/L

Her GP is concerned by the eosinophil count and calls the haematology team for advice. What questions would you ask and what advice would you give at this point?

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