What Causes Low Neutrophil Count?

Posted on Sat, 9 Apr 2016

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sat, 9 Apr 2016 Answered on

Tue, 7 Jun 2016 Last reviewed on

Question : WHAT DOES IS MEAN TO HAVE THE NEUTROPHIL COUNT LOW - 28.2 (RANGE IS 42 - 75) COMPARED TO THE LYMPHS WHICC SEEM TO BE HIGH - 51.6 (RANGE 20-50) WITH MONO AT 11.3% (RANGE 2-10) ON MY MOST RECENT BLOOD WORK. I HAVE RHEMATOID ARTHRITIS AND TAKE HUMIRA AND METHOTROXATE WEEKLY.

Answered by Dr. Dr. Ivan Romich (47 minutes later)

Brief Answer:
Side effect of medications

Detailed Answer:
Hi and welcome.
Lower neutrophils are consequence of metotrexate which is strong cytotoxic medication and has effectively on production of white blood cells. Lymphocytes are not significantly increased. This neutrophil count is tolerable and it won't lead to increased infection rate,however,if it falls progressively,you should reconsider methotrexate dosage with your rheumatologist. Wish you good health. Regards

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Dr. Ivan Romich (5 hours later)

What word did you want to put after the word "effectively" in your answer? Also, Is there a substitute drug you'd recommend instead of methotrexate which does the job of knocking down the RA symptoms of pain and inflammation, that won't lower the neutrohil count and/or raise the lymphs? Seems my Dr. is very concerned about the numbers with low neutrophil count compared to the lymph count. Please write back as that is the real answer that I am seeking. Thanks so much, XXXXXXX

Answered by Dr. Dr. Ivan Romich (7 hours later)

Brief Answer:
Hi

Detailed Answer:
mistake. I meant to say that it has negative effects on wbc production. Methotrexate dosage should definitely be reduced. It can be replaced with sulfasalazine or leflunomide,but if methotrexate works good for you then I wouldn't stop it completely,but better reduce it to previous dosage first and then check your neutrophils in 2 weeks.

Above answer was peer-reviewed by : Dr. Vaishalee Punj