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Forum Name: Hematology Topics

Question: High WBC (neutrophils), CRP, ESR, no symptoms


 dbunny - Wed May 27, 2009 5:38 pm

My doctor doesn't have a clue what to test next or who to send me to. I'm looking for some suggestions about what direction to go in next. I'm 37, 335lbs (have lost 40lbs recently through diet/exercise & still losing), Type 1 Diabetes (no complications, insulin pump, A1c's under 7%), Autoimmune Thyroid (TSH .5 currently), Asthma & uterine fibroids. I have mild fatigue (could be weight related?), no fevers whatsoever, no pain (except in my torn meniscus), no obvious infections, no swelling or recent illnesses.

On May 7th I was turned away for a meniscus surgery because of:
WBC 15,600
CRP 33.4
Platelets 513

All else on CBC, cholesterol, liver enzymes, thyroid, blood gases, chest x-rays, EKG, lung function all normal. Abdominal Ultrasound also performed, showed no gallstones, everything normal. Slight fatty liver beginning.

Three weeks after first blood tests. Again, everything normal range except:
WBC 12,200 (neutrophils 77%, low lymphocytes - no absolute numbers run)
CRP 25.5
1Hr Sedimentation Rate 37.5

Rheumatoid arthritis suggested (family history), but I can't get in to see a rheumatologist for blood tests like rheumatoid factor until mid-August (I'm outside the US currently & only specialists here can run those tests). What else could we check for in the meantime that would cause no symptoms and these blood results? I have no RA symptoms and I can't get my knee surgery until the problem is figured out..

Thanks,
Bunny
 Dr.M.jagesh kamath - Fri Sep 11, 2009 2:30 am

User avatar Hello,A very high CRP indicates a phase response.Best to get it repeated in 2 to 3 weeks time and persistence may mean infection , inflamation or a part of metabolic syndrome of diabetes.If it is the later you may be put on statins to prevent potential risks associated with increased CRP.The WBC and neurophil increase are only moderate and point towards infection.

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