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What Causes Abnormal Neutrophil, Monocytes Count And Leucocyte Counts In An RA Patient?
Question: I have RA- had it for approx 8 years now.
In the past I have taken, Humira, methotrexate, enbrel. I am now on Orencia and Leufuomide. My inflammatory markers, crp and esr are wnl now. I have a low neutrophil count, which I would expect because I am immune suppressed. My monocytes have hovered at 14% for over a year and half now. My rheumatologist is concerned and next month I am seeing a hematologist. (my ra is still active-stiffness, tired, pains)
should I expect a bone marrow bx?
thanks
In the past I have taken, Humira, methotrexate, enbrel. I am now on Orencia and Leufuomide. My inflammatory markers, crp and esr are wnl now. I have a low neutrophil count, which I would expect because I am immune suppressed. My monocytes have hovered at 14% for over a year and half now. My rheumatologist is concerned and next month I am seeing a hematologist. (my ra is still active-stiffness, tired, pains)
should I expect a bone marrow bx?
thanks
Brief Answer:
Hello dear. Yes, a marrow examination will tell the cause
Detailed Answer:
Hello dear. So patients on long-term methotrexate can develop pancytopenia including low total. Leucocyte counts which are likely due to methotrexate. Other causes in your age can be vitamin b12 and folate deficiency and myelodysplasia. A bone marrow can reliably differentiate between these.
However, I still feel methotrexate is the culprit.
Thanks and regards
Feel free to ask further
Hello dear. Yes, a marrow examination will tell the cause
Detailed Answer:
Hello dear. So patients on long-term methotrexate can develop pancytopenia including low total. Leucocyte counts which are likely due to methotrexate. Other causes in your age can be vitamin b12 and folate deficiency and myelodysplasia. A bone marrow can reliably differentiate between these.
However, I still feel methotrexate is the culprit.
Thanks and regards
Feel free to ask further
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Brief Answer:
Hello. Orencia and leflunomiide an cause neuteropenia as well
Detailed Answer:
Hello dear. So orencia as well as leflunomide can also cause neuteropenia.
A bone marrow examination is advisable to look for other causes as well as i mentioned previously.
Thanks and regards
Hello. Orencia and leflunomiide an cause neuteropenia as well
Detailed Answer:
Hello dear. So orencia as well as leflunomide can also cause neuteropenia.
A bone marrow examination is advisable to look for other causes as well as i mentioned previously.
Thanks and regards
Above answer was peer-reviewed by :
Dr. Yogesh D
I was more concerned about the monocytes at 14%
but thanks for your consultation
but thanks for your consultation
Brief Answer:
Monocytosis may represent an occult infection
Detailed Answer:
Hello dear. So monocytosis may represent an occult infection.
Thanks and regards
Monocytosis may represent an occult infection
Detailed Answer:
Hello dear. So monocytosis may represent an occult infection.
Thanks and regards
Note: Do you have more questions on diagnosis or treatment of blood disorders? Ask An Expert/ Specialist Now
Above answer was peer-reviewed by :
Dr. Raju A.T
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