Vacuolated neutrophils are often indicators of an infection such as sepsis or E Coli. So I’m really happy that @pepin31219 wasn’t having any ongoing infection.
With their notoriously low neutrophil count, no wonder there was panic with finding VNs in blood tests. But there’d also have some indications of an infection by that point.

@pepin31219 A theory is that you were exposed to some bacteria and your immune system, though weak, recognized the bacteria as an invader and launched an attack. That would have further lowered your limited peripheral neutrophil count so that it measured non-detect while whatever neutrophils were available were fighting the bacteria.

The neutrophils would have regenerated by the next blood test as the battle was over. In one of your subsequent blood tests, was there a result for LDH lactose dehydrogenase? It looks for signs of tissue damage in the blood.

LDH is an enzyme found in almost every cell of the body. The enzyme turns sugar into energy. When cells are damaged or destroyed, this enzyme is released into the fluid portion of blood. So the LDH test measures the amount of LDH in the blood which can indicate an ongoing or recent infection.

With your disease though, I’m thinking you’re no stranger to LDH readings in your blood because of ongoing tissue damage. How advanced is your cryoglobulinemia? Are you on strong anti-inflammatory drugs like bortezomib or rituximab?