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  • 1.  Elevated CD4 Count

    Posted 25 days ago
    Good evening.  I have a 46FAAB on Genvoya and Zyrtec with persistent elevated CD4s.  In 10/2021 - CD4 1886 (44%), then went down to 1698 (45.9%) in March 2022.  Last labs at end of August - 2042 (44.4%).  Last labs show Lymphs (Absolute) 4.6, RBC 5.68, RDW 15.9.  Pt has possible Alpha Thalassemia Trait from 2018 lab.  Can the thalassemia cause elevated CD4s like this?

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    Toni Steres
    Round Lake Beach IL
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  • 2.  RE: Elevated CD4 Count

    Posted 24 days ago
    Those CD4s seem normal to me based on the absolute count. There is quite a range on a normal absolute- our lab is 496 - 2,186 cells/uL. Your percentages look in-line with normal ranges as well- so it seems unlikely there is some condition going on to cause over proliferation of CD4s specifically. I'm not aware of how thalassemia could impact the count--( except maybe if it somehow the shape of the RBCs being smaller or irregularly shaped made it appear like there were more of the other components in the blood, even if there aren't really more?-- that's a total random guess-- not based on any sort of evidence though). Either way- if thalassemia was playing a role- I would think it should be a fairly constant thing- not something that would change suddenly. I probably wouldn't pursue any work up based on this result alone. (Of course if the patient has any concerning symptoms or if their beta thal is a concern- could consider hematology referral.)

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    Kelly Farrow
    Rochester NY
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