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What Causes High Fluctuating WBC ?
Posted on
Thu, 8 May 2014
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Thu, 8 May 2014
Answered on
Wed, 28 May 2014
Last reviewed on
Question : Hi. I presented in early January with fever, diarrhea, fever, and nausea. I was prescribed a course of cipro for 5 days without success. Eventually the diarrhea went away. However when I went to emerg in mid XXXXXXX my LFT's were high AST and ALT. 249 range. They fluctuated for 3 months and now have returned to normal. However I still have high fluctuating WBC 11-18000 with my absolute nuestros were high as well 11.00 on a recent test. I did have one blood test 10 days ago where everything was on the high side of normal for the first time in 4 months?
I have had a brain CT, Abdo CT , upper GI scope ,test for leukemia - negative 2D echo and chest X ray- all normal. I have consulted with 4 Internist a GI Dr. and a hematologist.
I have had no appetite and have had weakness for four months now. My highest WBC was 17.8 3 weeks ago then rapidly dropping to the normal range 10 days ago?
I also am beginning to get depressed and cry quite easily. I also have severe treatment refractory OCD and am on a SSRI and benzos for the OCD.
The majority of the Internists believe it may be a Viral infection, however my LYMPH in my WBC remains in the normal range. A Dr. once told me that with a virus this usually is elevated.
Please advise.
Thank you.
I have had a brain CT, Abdo CT , upper GI scope ,test for leukemia - negative 2D echo and chest X ray- all normal. I have consulted with 4 Internist a GI Dr. and a hematologist.
I have had no appetite and have had weakness for four months now. My highest WBC was 17.8 3 weeks ago then rapidly dropping to the normal range 10 days ago?
I also am beginning to get depressed and cry quite easily. I also have severe treatment refractory OCD and am on a SSRI and benzos for the OCD.
The majority of the Internists believe it may be a Viral infection, however my LYMPH in my WBC remains in the normal range. A Dr. once told me that with a virus this usually is elevated.
Please advise.
Thank you.
Brief Answer:
Considerations
Detailed Answer:
Hello and thank you for sending the question.
Your question is a good one and I will work on provide you with some information and recommendations. From the information you have sent and the laboratory values I have reviewed it does appear that you have a fluctuating elevation of your total white blood cell count. When we look at the different types of white blood cells as you have stated the neutrophil count is moderately elevated. There are many considerations with this type of finding including viral infection, bacterial infection, inflammation or rarely a primary bone marrow disorder.
I can understand that these findings are generating significant stress and anxiety for you. What I find reassuring is that the remainder of your blood counts including your hemoglobin and platelet count remain normal. I think it would be reasonable for you to visit with a local hematologist can review all of your laboratory studies including the flow cytometry study which was likely previously sent. In addition it would be reasonable for your hematologist to work with a local pathologist who has special training in blood pathology to study your blood under the microscope. This type of examination can sometimes yield additional considerations.
Finally, if you continue to have symptoms which are not explainable and these findings on your complete blood count it might be reasonable for your hematologist to perform a bone marrow examination. This is a very routine type of hematology examination and is a relatively simple procedure. A bone marrow biopsy would allow your pathologist to examine both solid and liquid bone marrow specimens as well as requesting sophisticated studies of your bone marrow to rule out any underlying disease process. It seems unlikely that you have a bone marrow disorder but it is reasonable again to rule this out with more confidence.
What is also extremely important is that you continue to lead a very active lifestyle. This includes exercise at least 4-5 days per week. It also includes eating a very well balanced diet and attaining adequate amounts of sleep and rest. If you are not able to achieve these this can sometimes put stress on your body. Please work with your local primary care physician to achieve these goals.
Thanks again for sending the question. Please let us know for can help you any time again.
Dr. Robert
Considerations
Detailed Answer:
Hello and thank you for sending the question.
Your question is a good one and I will work on provide you with some information and recommendations. From the information you have sent and the laboratory values I have reviewed it does appear that you have a fluctuating elevation of your total white blood cell count. When we look at the different types of white blood cells as you have stated the neutrophil count is moderately elevated. There are many considerations with this type of finding including viral infection, bacterial infection, inflammation or rarely a primary bone marrow disorder.
I can understand that these findings are generating significant stress and anxiety for you. What I find reassuring is that the remainder of your blood counts including your hemoglobin and platelet count remain normal. I think it would be reasonable for you to visit with a local hematologist can review all of your laboratory studies including the flow cytometry study which was likely previously sent. In addition it would be reasonable for your hematologist to work with a local pathologist who has special training in blood pathology to study your blood under the microscope. This type of examination can sometimes yield additional considerations.
Finally, if you continue to have symptoms which are not explainable and these findings on your complete blood count it might be reasonable for your hematologist to perform a bone marrow examination. This is a very routine type of hematology examination and is a relatively simple procedure. A bone marrow biopsy would allow your pathologist to examine both solid and liquid bone marrow specimens as well as requesting sophisticated studies of your bone marrow to rule out any underlying disease process. It seems unlikely that you have a bone marrow disorder but it is reasonable again to rule this out with more confidence.
What is also extremely important is that you continue to lead a very active lifestyle. This includes exercise at least 4-5 days per week. It also includes eating a very well balanced diet and attaining adequate amounts of sleep and rest. If you are not able to achieve these this can sometimes put stress on your body. Please work with your local primary care physician to achieve these goals.
Thanks again for sending the question. Please let us know for can help you any time again.
Dr. Robert
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. Chakravarthy Mazumdar
Answered by
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