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Low WBC and low neutrophils??

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Ulcerative Colitis
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Taylorjo
New Member
Joined : Apr 2021
Posts : 16
Posted 5/16/2021 9:04 PM (GMT -6)
Hi everyone, I had some blood panels run since I’m newly diagnosed with proctitus. I had a quite a few test run and the Dr. would like to re-run a test for my white blood cells and my absolute neutrophils. They were both low WBC- 3.2 L and neutrophils-1.01 L
The funny thing is, I was having a weird rash from the mesalamine (cleared up now!) so I figured something would be weird. But I pulled up old blood work from 2017 and the same thing was there. WBC- 3.4 L and neutrophils- 1.23 L
I’m not sure why my Dr. didn’t say anything about it then? It sounds like this can be connected to many different things-viruses, auto immune stuff and of course more scary things like leukemia.
The test ordered is for leukopenia. Thoughts??
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CCinPA
Veteran Member
Joined : Dec 2014
Posts : 2148
Posted 5/17/2021 4:06 AM (GMT -6)
Those levels are slightly low -- WBC range is 4.0 - 11.0 and Neutrophils is 1.7 - 7.8. Doc is likely running more tests since they are a little lower than they were the last time. No idea how concerning that is. What meds are you on? Some of the immune suppressant meds can cause that.
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Taylorjo
New Member
Joined : Apr 2021
Posts : 16
Posted 5/17/2021 7:46 AM (GMT -6)
Hi CCinPA, I’m not on anything right now. I was on mesalimine for just over 4 weeks when I developed a strange rash. I stopped taking it and about 2 weeks after had my blood drawn. I take my birth control pill and that’s it. My GI just wrote me a new script for some steroid type enema but I haven’t filled it yet, waiting to see if my calprotectin levels are where they are supposed to be. Then I will decide if I’m going to use the enemas. Thanks for the reply, I’m just curious if it’s related to the rash but I’m not sure why they were so low before.
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VanJordan
Regular Member
Joined : Dec 2019
Posts : 428
Posted 5/17/2021 11:11 AM (GMT -6)
Low neutrophils is common in IBD. Either during an active flare, or due to immune suppression from drugs like prednisone. Since you're not on immune suppression, the low neutrophils are usually because the immune system is being depleted by all the fighting. Neutrophils are made from bone marrow and take a while to mature. When an IBD flare starts, all the mature ones go right to the bowel and start fighting. Then when they're used up, all the immature ones go and continue the fight. Eventually their numbers drop because the army just gets depleted. You can get a blood test to find out the ratio of mature to immature ones, I've had it done before when I had neutropenia.

You don't have to worry about below normal neutrophils unless you have symptoms like getting infections easily. A lot of people naturally have below average neutrophils and they're just fine.

I usually have low neutrophils within the first couple of months of stopping prednisone. I haven't been able to figure out why. Maybe something to do with cortisol trying to normalize, dunno.

I can't remember clearly right now but I think vitamin C, zinc, and iron are all crucial to neutrophil development.
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iPoop
Forum Moderator
Joined : Aug 2012
Posts : 16372
Posted 5/17/2021 11:30 AM (GMT -6)
What does your doctor think? Blood anomalies are a rare side effect with mesalamine, as well, maybe verify that's not you
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