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  • Elevated WBC, hematologist?

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    Old 01-23-2017, 08:53 AM   #1
    Lashigirl
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    Elevated WBC, hematologist?

    Hi all, recent labwork done after complaints of ongoing thigh pain, perhaps muscles/joints or thigh bone. Hard to tell. Anyway results were a little concerning. I do have Auto-immune thyroiditis (being treated with hormone supplementation) which can cause inflammation and join/muscle pain but labs ordered to rule out other possible causes nonetheless. Double-stranded DNA for Lupus and RF factor negative. ANA test is still pending. Doc is referring me to Rheumatologist regardless but I'm wondering in hindsight if hematologist referral should have been made as well. I know the WBC and Neutrophils aren't crazy high, however I do not have any viral or bacterial infections going on (that I'm aware of and I think I would be having symptoms of those at that level) and inflammation markers below are not revealing any inflammation (ESR and CRP). Looked back at previous WBC counts in last 6 months and they were: June, 10.3 October, 11.3 January 6th, 10.8 and now January 18th, 14.6. Neutrophils are always the highest contributing factor to the overall elevated result. I guess my question is, have others ultimately been referred for similar levels and should I push to have this further investigated or am I being overly worried? Normally I would likely chalk this up to the Thyroid but given the apparent absence of inflammation/infection, it's a bit worrisome. Not likely to get in to see Rheumatologist for several months and not sure I want to worry about this for that long before additional CBCs are run, which I'm sure he'll run in addition to other tests for RA.

    WBC 14.6 (4.0-11.0 xE9/L) - HIGH
    Neutrophils 11.0 (2.0-7.5 xE9/L) - HIGH
    Lymphocytes 2.9 (1.0-3.5 xE9/L)
    Eosinophils 0.1 (0.0-0.5 xE9/L)
    Basiophils 0.0 (0.0-0.2 xE9/L)
    ESR 2 (2-30 mm/h)
    Creatine Kinase 31 (33-165 U/L) - LOW
    CRP .5 (<6.0 mg/L)

     
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    Old 11-20-2018, 05:51 PM   #2
    Lashigirl
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    Re: Elevated WBC, hematologist?

    Hi everyone,
    Thought I would post an update. Several more labs done since last year with very similar results (I have regular blood work done on account of Hypothyroidism). In addition my rbc's, hemaglobin and hematocrit are continuously coming back elevated. Doctor called me in after most recent lab in October and said she is referring me to hematologist. Funny enough, I didn't even have to ask; they initiated it. Seems the high wbcs didn't concern her but seeing the rbc values chronically high is more concerning to her. On another note, I did see the Rheumatologist as mentioned in my previous post and he diagnosed me with Fibromyalgia although that's a hard diagnosis for me to accept. Mainly because there is no lab or test other than clinical picture and tender point exam. I continue to have chronic hip, thigh pain and now my feet as well.
    Lots of other symptoms such as fatigue, brain fog, headaches, dizziness but those are general and overlap with hypothyroid and fibro. Anyway, appointment with Hematologist is November 29th so I will post an update thereafter even if it turns out to be nothing worrisome.

     
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    Old 11-21-2018, 11:47 AM   #3
    quincy
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    Re: Elevated WBC, hematologist?

    Hi....have you had an MRI or visual of your lower back and hips?

    Are you on any other medications such as for blood pressure?

    I went through a long stint with hip issues, turned out to be bursitis.
    If you can get in to see a sports medicine doc for your hips, I suggest that.

    What are your liver enzyme tests like?

    I hope the hematologist has some insight.
    q
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    Last edited by quincy; 11-21-2018 at 11:48 AM.

     
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    Old 11-21-2018, 05:52 PM   #4
    Lashigirl
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    Re: Elevated WBC, hematologist?

    Quote:
    Originally Posted by quincy View Post
    Hi....have you had an MRI or visual of your lower back and hips?

    Are you on any other medications such as for blood pressure?

    I went through a long stint with hip issues, turned out to be bursitis.
    If you can get in to see a sports medicine doc for your hips, I suggest that.

    What are your liver enzyme tests like?

    I hope the hematologist has some insight.
    q

    Last edited by Lashigirl; 11-21-2018 at 05:58 PM. Reason: Hi Quincy, my ALT and ALP and billirubin were normal. I've not had an MRI but they did do an ultrasound of my right hip.

     
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    Old 11-21-2018, 06:01 PM   #5
    Lashigirl
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    Re: Elevated WBC, hematologist?

    Hi Quincy,

    They did do an ultrasound of my right hip at the same time I got the X-rays done. No arthritis or bursitis in the hip. My ALT and ALP were both within range and so was Bilirubin although the ALP was towards the top end of the range.

     
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    quincy (11-22-2018)
    Old 11-22-2018, 11:30 AM   #6
    quincy
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    Re: Elevated WBC, hematologist?

    Hi....good no arthritis or bursitis.

    Sometimes if liver enzymes are increased in specific pattern, it can point to something in relation to other tests. With them still in normal range, it seems blood specific.... and it's good that you're seeing a hematologist soon.

    Are you on any meds for pain?

    Please post an update after you see the specialist.

    q
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    Last edited by quincy; 11-22-2018 at 11:32 AM.

     
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    Old 11-29-2018, 11:15 AM   #7
    Lashigirl
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    Re: Elevated WBC, RBC, Hemoglobin, Hematocrit - hematologist?

    Quick update.

    Has my haematology appointment today. More blood work done to test for JAK2 mutation, EPO and Ultrasound ordered for enlarged Spleen found upon examination. Higher than normal heart rate (100) observed during appointment today.

    To add some context, last CBC differential showed:
    WBC 13.3 (range 4-11) HIGH
    RBC 5.15 (range 4-5.10) HIGH
    Hemoglobin 167 (range 120-160) HIGH
    Hematocrit .480 (range .350.450) HIGH
    Platelet 313 (range 150-400) NORMAL

    Symptoms include headaches, pruitis, red eyes, pain in lower extremeties and lower back, dizziness, red dots on palms of hands (red "flecks" non blanching) but no where else, digestive issues, hot flushes and extreme fatigue.

    Won't know results for about a month so likely to post another update then, even if it's nothing.

    Doc mentioned possible Polycythemia Vera but also could be just my body adjusting to fact that I had endometrial ablation and no more menorragha.

    For those with PV, what were your rbc, hbg and hct levels at diagnosis?

     
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    Old 11-29-2018, 10:32 PM   #8
    quincy
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    Re: Elevated WBC, RBC, Hemoglobin, Hematocrit - hematologist?

    Oh wow...i have no knowledge of PV.....I hope others with experience or knowledge of it will answer your queries.

    Hugs,
    q
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    Last edited by quincy; 11-29-2018 at 10:34 PM.

     
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    Old 01-02-2019, 06:33 PM   #9
    Lashigirl
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    Re: Elevated WBC, RBC, Hemoglobin, Hematocrit - hematologist?

    Quick Update - got test results back today. Ultrasound came back with no significant findings however I tested positive for the JAK 2 mutation (V167F). Have been placed on daily low dose of aspirin and will be scheduled for a follow-up for possible phlebotomy and bone marrow biopsy and potentially testing for other gene mutations common to myleproliferative neoplasms.

     
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