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Here is a concise summary of the blood report for Mr. MD Gulzar (Male, 25 years), dated 11 July 2026:
Blood Report Summary
Lab: Fully Automated ERBA-H-560 (5-part differential)
Reported by: Dr. Alok Kumar, DCP MD Pathologist
Normal Findings
| Parameter | Result | Status |
|---|---|---|
| Haemoglobin | 13.3 g/dL | Normal (12.5-18) |
| Total WBC | 8,600 /cmm | Normal (4,000-10,500) |
| RBC | 4.9 mill/cmm | Normal (4.5-6.5) |
| PCV | 42.1% | Normal (37-54) |
| MCV | 86.09 fL | Normal (82-98) |
| MCH | 27.2 pg | Normal (27-33) |
| RDW-CV | 13.9% | Normal (11-14.5) |
| Neutrophils | 63% | Normal |
| Lymphocytes | 28% | Normal |
| Monocytes | 2% | Normal |
Abnormal Findings (Flagged)
| Parameter | Result | Reference Range | Remark |
|---|---|---|---|
| Platelet Count | 1,05,000 /cmm | 1,50,000-4,50,000 | LOW (Thrombocytopenia) |
| Eosinophils | 7% | 0-6% | Slightly HIGH |
| Absolute Eosinophil Count | 602 /cmm | 0-400 | HIGH (Eosinophilia) |
| MCHC | 31.59% | 32-36% | Slightly LOW |
| MPV | 13.2 fL | 6.5-12.0 | HIGH (Large platelets) |
Key Clinical Takeaways
- Thrombocytopenia - Platelet count is notably low at 1,05,000 (normal starts at 1,50,000). This warrants follow-up, especially to rule out dengue, viral infections, or other causes.
- Eosinophilia - Mildly elevated eosinophils (7%, absolute count 602) may suggest an allergic reaction, parasitic infection, or drug reaction.
- High MPV with low platelets - Large platelet size alongside a low count often indicates increased platelet turnover (the bone marrow is producing platelets rapidly to compensate).
- Mild low MCHC (31.59%) - Borderline low, may suggest a very mild tendency toward hypochromic red cells, but other red cell indices (MCV, MCH) are normal.
- Haemoglobin is normal - No anaemia at this point.
Recommendation: The combination of low platelets + eosinophilia in a 25-year-old male should be correlated with clinical symptoms (fever, rash, travel history, drug intake). A dengue NS1/antibody test and peripheral smear review may be advisable.
What could cause this low platelet count and eosinophilia?
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Here is a thorough, textbook-backed answer for the findings in MD Gulzar's report.
Causes of Low Platelets (1,05,000) + Eosinophilia (7%, AEC 602)
The combination of these two findings in a 25-year-old male in July (monsoon season in South Asia) points strongly toward a handful of unifying diagnoses. Let's break each finding down and then find where they overlap.
1. Low Platelet Count (Thrombocytopenia)
Per Henry's Clinical Diagnosis and Management by Laboratory Methods, the major mechanisms are:
| Mechanism | Examples |
|---|---|
| Increased destruction (immune) | ITP, viral infections (HIV, EBV, dengue), drug-induced |
| Increased destruction (non-immune) | Sepsis, DIC, TTP/HUS, hypersplenism |
| Decreased production | Bone marrow suppression (aplastic anemia, leukemia, drugs, B12/folate deficiency) |
| Splenic sequestration | Any cause of splenomegaly (malaria, liver disease, etc.) |
The high MPV (13.2 fL) here is a critical clue. A high MPV with low platelets means the bone marrow is actively producing large, young platelets to compensate - this pattern is classic for increased peripheral destruction, not reduced production. As confirmed by Harriet Lane Handbook: "Large platelets suggest increased marrow production in destructive processes (e.g., immune thrombocytopenia [ITP])."
2. Eosinophilia (AEC 602, mildly elevated)
Per Henry's Clinical Diagnosis and Management and Quick Compendium of Clinical Pathology, reactive (secondary) eosinophilia - the far more common type - is driven by IL-5 overproduction, and its causes include:
- Allergic/atopic conditions (asthma, allergic rhinitis, eczema)
- Parasitic infections - especially tissue-invasive helminths (roundworm, hookworm, Toxocara, Trichinella, filaria)
- Drug reactions
- Collagen vascular / autoimmune disease (SLE, vasculitis)
- Hematologic malignancies (lymphoma, HES) - usually cause higher counts
At 602 /cmm, this is mild eosinophilia - most consistent with allergy or helminthic infection, not malignancy.
3. Unifying Diagnoses (Both Findings Together)
| Condition | Low Platelets | Eosinophilia | Notes |
|---|---|---|---|
| Dengue fever | Yes - hallmark | Occasionally mild | Most likely in monsoon season; leukopenia also expected |
| Helminthic infection (filaria, toxocariasis, hookworm) | Yes - immune-mediated | Yes - classic | Travel/rural exposure history important |
| Malaria (especially P. falciparum) | Yes - splenic sequestration + destruction | Mild, possible | Fever, chills, travel history |
| Drug reaction (DRESS syndrome) | Yes | Yes - characteristic | Recent new drug use? |
| Viral infections (EBV, CMV) | Yes - immune | Occasionally | Fatigue, lymphadenopathy |
| ITP + separate allergic eosinophilia | Yes | Yes (coincidental) | Two separate problems |
| SLE / autoimmune | Yes | Possible | Less likely at 25M without other features |
Most Likely Scenario
Given:
- 25-year-old male
- July (peak monsoon / dengue season in India)
- Platelets at 1,05,000 (moderate drop, not critically low)
- High MPV = active platelet turnover (destruction)
- Mild eosinophilia
Top priority to rule out:
-
Dengue fever - Order NS1 antigen (best in first 5 days of fever) and IgM/IgG antibodies. Dengue classically causes thrombocytopenia + leukopenia; eosinophilia can occur mildly. Per Andrews' Diseases of the Skin: "thrombocytopenia (platelet count <100,000 in 50% of patients)" is a hallmark of dengue.
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Helminthic / parasitic infection - Stool microscopy for ova & parasites, serology for filaria or Toxocara if clinically suspected.
-
Malaria - Peripheral smear (thick & thin) + RDT if the patient has fever.
-
Drug-induced reaction - Review any medications taken recently (NSAIDs, antibiotics, anticonvulsants).
Recommended Next Tests
| Test | Why |
|---|---|
| Dengue NS1 antigen + IgM/IgG | Rule out dengue (most urgent in monsoon) |
| Malaria peripheral smear + RDT | Rule out malaria |
| Stool ova & parasites | Helminthic infection |
| LFT (liver function tests) | Dengue, malaria, viral hepatitis all affect LFTs |
| Serum LDH + uric acid | Hemolysis / dengue severity marker |
| ANA / anti-dsDNA (if systemic symptoms) | Rule out SLE |
| Blood culture (if febrile) | Bacterial sepsis causing DIC |
Note: This analysis is for educational/clinical orientation purposes. Final interpretation must be made by a qualified physician who can assess symptoms, examination findings, and complete clinical history.
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