What's your WBC value, and what does your test consider to be a normal range?
>my white blood count is dangerously low. What does that mean?
The reason we get our blood tested while on azathiopurine/imuran/6MP is exactly because of this. At any time, our blood vales WBC, RBC, platelets, Neutrophils, etc) can drop to low levels. That can happen when first starting Imuran or years later.
>She mentioned bone marrow too?
Imuran slows the level in which our body can make new WBCs and it does this by acting on bone marrow (which is where all of those blood elements are manufactured within our bodies). Your bone marrow is fine. The medicine is acting too strongly within your body, causing more suppression than is desired. It's called Myelosuppression in medical jargon. Ceasing or reducing dosage of Imuran will restore you to normal blood test results in approximately 6-8 weeks.
This happened to me with Neutrophils. I had been on 6MP about
2 years, then my Neutrophils starting trending lower, we watched it over a series of months. Doc said let's reduce your dosage from 75mgs to 50mgs. We did that and about
6-8 weeks later my numbers returned to normal levels. I staid at 50mgs for another 6-months then was able to go back up to 75mgs and remained there for additional years.
>What can happen?
You are more at risk of infections normally, and that risk jumps if your WBCs are very low. WBCs are your immune system's attack dog, eliminating things that cause infections from our bodies. With low WBCs your body is less able to fight off infections. I would be more cautious around those that are sick, and use good hand washing practice. If you suspect you have an infection needing antibiotics (UTI, bronchitis, sinus, etc) then you should see your doctor promptly for antibiotics. Worstcase scenario is Sepsis, an infection spreading and becoming blood born, unlikely. NSSG had sepsis and was in ICU, it's pretty scary crap. Do not mean to scare you, but do want you to be aware of all likelihoods even those that are low risk.
>is there something I can do? I want to go back on azathioprine.
Be cautious about
infections/cold/flu, wait 6-8 weeks, and then watch your future blood tests. I was fine, and I imagine you will be too. So do not panic.
As far as your future treatment with Imuran goes, I'd wait until your WBCs come back to normal levels. Then you can discuss restarting at a lower dosage with more frequent blood work for a while. Your doc may be for this or against this. Depends on more variables than you've shared (history, doc preference, other blood values, etc).
Moderator Ulcerative Colitis
John, UC Proctosigmoiditis in Remission
Rx: Remicade @5mgs/kg/6wks; 50mgs 6MP; nightly RowasaI knew I was in for trouble when my bowels started making the same noises that alien from the movie Predator (1987) did...
Post Edited (iPoop) : 10/21/2019 6:51:56 AM (GMT-6)