Why does this patient have Monocytosis?

When the Consult Service is called about a patient with B-symptoms and monocytosis, it is easy to jump immediately to the bone marrow biopsy. Before the bone marrow biopsy, hematologist, Dr. Toyosi Onwuemene, discusses why a broad differential should be considered.

[@elspinartifact6628]

I am 25 years old and have monocytosis (14%) and low HDL. I have no other symptoms, any idea on what’s going on? I am a medicine student

[@venomx4093]

I am currently going through this as a patient. Weight loss 2 years ago, but has since stopped. I actually gained some weight. A period of night sweats, bone pains that has stopped. Gastro issues that are ongoing. Vision issues, hydronephrosis in 1 kidney supposedly due to kidney stones. Monocyte count was 1300, but the percentage is 7.4%. Neutrophils were 14,500 and at 81%. Lymphocytes are 1600, but at 9.4% very low. I do have hypothyroidism as well. CMML thoughts has me nervous. I'm hoping it's lupus.

[@plamennonchev7422]

Hey, doc. I’ve had elevated monocytes(everything else in range) for the past three months. I went to a haematologist and she told me not to be concerned unless symptoms appear. Do you think I should push for a bone marrow biopsy to make sure the cause is not malignant. I’m 24 years old by the way.

[@tamanvayagarwal6622]

Hi are you good?

[@mistachubbsable]

This is weird thats not even a real person. THATS AI. CRAZY!!!