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Forum Name: Hematology Topics

Question: low wbc /low lymphocytes


 oldakasha - Wed Mar 14, 2007 9:24 am

I am a 26 year old female. I have had a low WBC for at least a year now but it has just gotten worse. I had been told before that I was neutropenic with neutrophil counts between 400-1000 but that my total WBC was always normal. Over the course of the last year my total WBC has been dropping and I am not sure why.

I have a total WBC of 2.2

Granulocyte 1.6
Lymphocyte .5
monocyte .1

I was told my levels were critically low. I am HIV negative. I have been having pains and numbness in my limbs burning sensations in my hands and feet. My legs have been twitching and sometimes I get this feeling like I am being poked and then it send a weird sensation up my leg or arm. I an very fatigued and sometimes feel very dizzy. I am not sure this is releated to my WBC but thought I would mention these symptoms.I am just very tired and am having a hard time getting help in any hurry. Any knowledge would be helpful.
 Dr. Chan Lowe - Wed Mar 14, 2007 4:59 pm

User avatar I have a few questions for you to help me narrow in on a good answer for you.

1) Are your hemoglobin/hematocrit and platelet numbers normal?
2) Do you get infections commonly? If so, what kind of infections do you get (bacterial (which bacteria), viruses, fungal)?
3) Have you had any other blood tests done?
4) Have you seen any specialists?
5) How long has your WBC count been low?
6) How low was it before it became this low?

Thanks.
 oldakasha - Wed Mar 14, 2007 7:08 pm

Here are the rest of my results:
MCH 32.3 H
MCHC 35.3
RDW 11.4 L
PLATELETS 228
mPV 6.8 L
RBC 4.21
HGB 13.6
HCT 38.5
MCV 91.6



When I was first told I was neutropenic( I was 22 years old) I had counts neutrophil counts between 400-1100. I got strep throat all the time occasional pneumonia and skin rashes a lot.
My total WBC at that time were between 4.5-5.1 with only the neutrophil count low. I went to a hematologist and had a bone marrow biopsy done. THe results of that say:
peripheral smear :neutropenia
bone marrow:hypocellular bone marrow with granulocytic hypoplasia and decreased megakaryocytes

I was put on GCSF shots and had some raise in my counts. Then in 2004 I became pregnant and went off the shots. During my pregnancy my blood counts stayed in normal rannge and doctors said I didnt need to go back on my shots. Now in the last year my physician has told me my white blood count is low even though my neutrophil count is still in normal range it has been around 3.0-3.5. About 2 months ago I went into my doctor and told her about this numbness, pain, and tingling, burning I was having in my hands elbows knees and feet. She checked my counts and they were at 3.3. She did a blood test for RA and said it was negative and my glucose levels were normal. Despite this she said she felt like I needed to go to a Rheumatologist but my appt is 2 months away. I went in this week because I am still having these different sensations and I have been getting light headed,very tired, dizzy and just generally weak. THey called and said that I had a critically low WBC and I needed to see a hematologist again but I have not been seen by a hematologist since 2004 so I don't currently have one and have to wait for refferals to go through ect before I can even attempt to get an appt.
Should I have another bone marrow biopsy done?
I am very concerned about the change because it is not just my neutrophils that are low this time. it is the total WBC and the lymphocytes as well. Your help is very appreciated.
 Dr. Chan Lowe - Wed Mar 14, 2007 7:25 pm

User avatar Looking at your results, your hemoglobin/hematocrit and platelet numbers are normal. This brings you into a category called isolated leukopenia. At this point, the diagnostic strategies get fairly complex. Possibilities include cyclic neutropenia (less likely given you seem to never really be normal), autoantibodies to the white blood cells or white blood cell precursers, myelodysplasias of the bone marrow or other rare conditions.

A repeat bone marrow may be helpful. Evaluation by a hematologist is likely your best place to start. A rheumatologist may also be helpful.

Best wishes.

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