Worried about DP's blood results

[LemonSherbetFancies]

DP like some others in my family has RA.
He has been monitored with blood tests since December last year, slight rise in neutrophils but otherwise, was told all good.
Even last week he spoke to his RA nurse and she said all was fine with his bloods. Yesterday however, he got a write up of his phone call with her and his results were abnormal.
His neutrophils were 7.9, MCV 101 and most worrying, platelets were 161. So why was he told all was fine? I am very angry about this and also worried as when I researched it says high platelets can indicate cancer.
Should I encourage him to put in a complaint?

If his bloods are always in that range then they'll say normal even if they're slightly out of range. At least that's how it works at my hospital, my neutrophils are always raised when I'm in a flare.

Have you got the wrong figure for platelets there? Normal in most labs is 150-400ish so 161 is completely normal. Lots of RA drugs increase the MCV (esp azathioprine for eg)

Sorry I meant 461.

Even last week he spoke to his RA nurse and she said all was fine with his bloods.
Do you know what he was told, or what he told you he was told?

I am very angry about this
What does he think about it?

Ok, first thing is 'normal ranges' in blood results aren't necessarily normal for everyone. They are calculated from a normal distribution graph, and cover 90% of results - 5% at the bottom and 5% at the top will be outwith the labs 'normal range' but actually completely normal for that individual person.

As far as platelets go, the commonest cause by far for high platelets is active inflammation. The slightly raised neutrophil count would also suggest he has some active inflammation going on- not unexpected if he has RA. I've just double checked the ranges and normal is up to 450 so 461 is only very very borderline raised.

I'm a GP who looks at these sorts of results every working day. It's very unusual for RA patients on active treatment drugs to have bloods that are completely in the normal range for every single indicator, partly due to the actual disease and partly due to the medication. Presumably he is having regular bloods and they are due to be repeated reasonably soon?

By all means he could ask to clarify the results with her, but I would really advise against going in all guns blazing with a complaint. His relationship with his rheumatology nurse is incredibly important for his ongoing care and management (even more than usual now with out patient appointments being delayed all the time) so I really wouldn't risk affecting that with an unnecessary complaint.

Thank you. It's reassuring to hear from a GP. I think the platelet count worried me most as it can indicate cancer which has terrified me.
Everytime he calls in for his results, he is told they are good and fine. These were her exact words. He has been having regular bloods since last November I think and always been told bloods are fine except the rise in neutrophils. So the platelets reading was a shock.
He is on methotrexate and prednisolone at the moment which I read can also contribute to the elevated readings in platelets, neutrophils etc. Just hard not to worry as can't help but think they may overlook something or not really looked at them properly.