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Forum Name: Hematology Topics

Question: Elevated WBC, Leukocytes and Neutrophils


 robbeth90 - Wed Nov 12, 2008 12:19 am

I have recently changed dr's looking for someone not so eager to pass out pills for anxiety. My dr. looked at some old blood tests I took to him and ordered a repeat. My CBC came back with high WBC of 14.1, high neutrophils of 9.6 and high leukocytes of 3.57. The issue is I looked at some of my lab results since 2005 and everyone I seen shown a combination of 2 or 3 of these high on them all. Now he wants to send me to a hematologists and I am scared I have leukemia or some dreadful disease. Has anyone else had these kinds of numbers and what was your diagnosis?

Thanks,
 Dr. Safaa Mahmoud - Wed Nov 12, 2008 4:06 pm

User avatar Hello,

Normal values for while blood cell and its elements are:
4,500-10,000 white blood cells/mcl.
Neutrophils: 40% to 60%
Lymphocytes: 20% to 40%
Monocytes: 2% to 8%
Eosinophils: 1% to 4%
Basophils: 0.5% to 1%
Band: 0% to 3%

Elevated Total leukocytic count can occur in different condition like infections (bacterial, viral or fungal), systemic disease (e.g.inflamtory bowel diseases and vasculitis), physical stress, cancer especially hematologic malignancies.

Specific increase in one blood element is more indicative of certain medical conditions, e.g neutrophilia (like in your case) in most infections and tissue damage like inflammatory and metabolic diseases. Smoking is well documented to increase the white cell count especially neutrophils.

Although a higher than 11,000 white cells/mcl of blood is considered high, in leukemias the white blood cell counts can reach 100,000.
An elevated ESR, LDH or CRP would be helpful and would make inflammatory changes more likely although not conclusive.

Transient elevation of the white blood cells is not warning but should be properly approached. Serial CBC follow up is essential.
On the other hand, persistent elevation in the white blood cell count should be investigated properly to exclude both chronic systemic inflammatory conditions and malignancy.

I would advise you to follow up with your doctor.
Please keep us updated.
Best regards.
 robbeth90 - Wed Nov 12, 2008 4:38 pm

Thank you for your time in answering. My first office visit with this dr and I feel he has already done more for me than the last 4 years with the other dr. I think I forgot to mention that my Thryoid test have all went down in the last 4 years also. My T4 in 2005 was 1.39 and October 2008 it was .99, my TSH also but I don't have the numbers; this is along with the elevated wbc. He is scheduling me for a thyroid ultrasound as well as an appointment with a hematologists. I will follow through with testing and pray. Again, thank you for your response.
 Dr. Safaa Mahmoud - Wed Nov 12, 2008 5:34 pm

User avatar Hello,
This may be also be a cause of your CBC results.
One of the causes of hypothyroidism is Hashimoto's Thryoiditis, it is an autoimmune condition that results in inflammatory changes in the thyroid. This end results in hypothyroidism after initial elevation of the level of thyroid hormones. The normal level of adult FT4 is in the range of 0.8-1.5 ng/dl.

If you develop a chronic thyroiditis state there might be also an increase in the white blood count since they are the cells that defend our bodies against any inflammation or infection or any foreign body.

Thyroid peroxidase (TPO) antibody is used to detect antibodies against the thyroid gland in Hashimoto's Thryoiditis. Most people with chronic thyroiditis (70%-90%) are positive for TPOAB test.

I advise you to follow up with your doctor and to recheck your thyroid function tests. Your doctor may consider an endocrinologist consultation if the thyroid function tests are not in the normal range.

Hope you find this information useful.
Please keep us updated.
Best regards.
 robbeth90 - Thu Nov 13, 2008 6:02 pm

Thank you very much. My thyroid issue really doesn't scare me as much as the other blood work does. My first thought is leukemia.... but I am trying not to let my imagination get away from me. My ultrasound is scheduled for next Tuesday and I am waiting on the appointment with a hematologist. Again, I really appreciate your response and I am glad there is a service like this one available to help ease minds.

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