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Forum Name: Hematology Topics

Question: Chronically Elevated Neutrophils


 ChristineVA - Wed Feb 15, 2006 9:49 am

I am a 42 y/o female, not overweight, non-smoking, and have anxiety disorder. Last August 2005, my psychiatrist wanted to evaluate my bloodwork to look for any physical causes of anxiety. Everything fell within the normal range except for my absolute neutrophil count which was 8302 (range was 1500-7800).

Recently, I visited my GP to get to the root of some ongoing tachycardia that I had. A complete blood chemistry, EKG, and echo were run. All were normal except the neutrophils again. Here are my January labs:
WBC Count = 8.1 (4.0-10.5 range)
RBC Count = 3.93 (3.80-5.10)
Hemoglobin = 11.8 (11.5 - 15.0)
Hematocrit = 35.9 (34.0 - 44.0)
MCV = 91 (80-98)
MCH = 30.0 (27.0-34.0)
MCHC = 32.9 (32.0 -36.0)
RDW = 13.2 (11.7-15.0)
Platelets = 267 (140-415)
Neutrophils = 81 (40-74)
Lymphs=- 14 (14-46)
Monocytes= 5 (4-13)
Eos = 0- (0-7
Basos = (0 -3)
Absolute Neutrophils = 6.6 (1.8 - 7.8)
Absolute Lymphocytes = 1.1 (.7 - 4.5)
Absolute Monocytes = 0.4 (0.1 - 1.0)
Absolute Eos - 0 (0.0-0.4)
Absolute Baso = 0 (0.0 - 0.2)

So, after this visit, my doctor gives me Verapamil SR to help with the tachycardia. I have an allergic reaction to it after only two pills. I got a slight rash from it that went a way. A day or two later, I get petechecia on my back, sides of waist/ribs, hips, buttocks and upper thighs. I return to my doctor (this is February) and he runs all my bloodwork again to check for blood counts. He also runs different clotting tests (not sure of the names). Again all is well, except for the darned neutrophils which at this time are at 77 versus 81 (still elevated over the norm). Yet my complete counts are all within the normal range.

With my anxiety disorder, it is VERY difficult for me to be calm with this. My doctor tells me that he is not concerned with this. My allergic reaction and resulting petechiae have not helped.

So my question is: in the presence of everything else being normal, what does a slightly elevated neutraphil count mean, if anything.

The medications I take are:
Synthroid (thyroid cancer in 1995 treated, no evidence of disease)
Prilosec for GERD.

I have not had any colds or infection in quite some time. I did have two excision breast biopsies in late November.

Will anxiety cause this condition? I feel very panicky most days, especially when at the doctor.
Thank you,
Christine
 Theresa Jones, RN - Wed Feb 15, 2006 10:16 am

User avatar Hi ChristineVA,
Physical, emotional stress, etc., can affect white blood cell counts and cause elevations in the absence of infecton, inflammation, etc. I will insert a link in this post for you to view if you would like to do so.
afp/20001101/2053.html" class="postlink">Click here!
Sincerely,
Theresa Jones, RN
 ChristineVA - Wed Feb 15, 2006 10:55 am

Thank you for the link. I was confused though. The article talks about leukocytosis (which is elevated white blood cell count if I understand correctly). My WBC appears to be normal, yet my neutrophils are elevated. I guess that's the part that has gotten me confused?? Does my situation relate to this article since my WBC is normal?
Thank you,
Christine
 Theresa Jones, RN - Wed Feb 15, 2006 11:13 am

User avatar Hi ChritineVA,
Neutrophils/ polymorphonuclear cells are the mature cells in the white blood cell count. White blood cells consist of Neutrophils/Granulocytes, Monocytes, Lymphocytes, Basophils, Eosinophils each responsible for different actions. I hope this clears up the confusion.
Sincerely,
Theresa Jones, RN
 ChristineVA - Wed Feb 15, 2006 11:20 am

Okay, I guess my confusion lies in what does elevated neutrophils mean when the overall WBC is normal.
 Theresa Jones, RN - Wed Feb 15, 2006 11:31 am

User avatar Hi ChristineVA,
Mildly elevated neutrophils can essentially be a result of physicial or emotional stresses and not related to any specific condition or disease process, when there are no concerning symptoms and all other lab values are normal. Since you have had a recent exam, and your physician considers this finding unconcerning at this point, in my opinion, I would not worry. If your counts would change overall or other inconsistencies would appear then I am sure his/her recommendation would be to refer you to a Hematologist for an evaluation.
Sincerely,
Theresa Jones, RN

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