Blood work

[Lara1]

Has anyone noticed abnormal blood test results (high leukocytes, neutrophiles, lymphocytes count and ESR) ONLY when under steroid or immunosuppressive treatment (everything goes back to normal when treatment is stopped)? In my understanding such abnormal results are a marker of inflammatory disease so why would they show up when under treatment for the disease?? Any ideas?

thanks

L.

[andreafm]

Hi there lara

High Blood test results could also mean you are fighting and infection.

Infections are common when on Immune Suppressants and Prednisolone as they lower the immune system. These blood tests can therefore rise  if your body is trying to fight an infection or if you have Inflammation

Strangely, I didn't have any abnormal test results for many years even though I had Behcets Symptoms. It wasn't until I started to have Neurological Symptoms, that the ESR rates went high and they haven't been in the normal range since. My Consultant takes these results as Inflammation is still existing....so it isn't a straight forward answer

Your consultant would know more about how they are reading your blood test results in particular and so you might like to ask them what they think

Hope this helps

[Lara1 in reply to andreafm]

Hi Andrea

Thanks for your message. I also have not had abnormal blood test results until recently (my first big flare was in 2013). I do not have any symptoms of infection so I have no idea what the cause may be except behcet's. What worries me is that the results seem worse when under immuno-suppressive treatment (Solu-medrol). Could it be that the treatment makes the disease worse?

[andreafm in reply to Lara1]

Hi Lara

I know just how puzzling blood tests can be and being on immuno-suppressive treatment medications can disguise symptoms of an infection if you have an infection.

Infections act differently when you are having these medications and often enough with me...... I don't realise there is an infection as well as a flare of behcets....it's hard to tell sometimes as some of the symptoms are similar.

That doesn't mean I think you have an infection...it just means that's another reason for your blood tests being high, other than there being inflammation from your behcets.

If your Behcets is still active at the time of having the blood test it could mean that it isn't under control at that time......and not making it worse. 

Are you having the Solumedrol because of a flare or as a regular treatment?

My consultants use the high blood test results to tell them if my behcets is still active and I need to continue with the Immune suppressants and so this might be the same for you.

Hope this explains what I mean

[Lara1]

Hi Andrea

I had to have solumedrol as I took Copaxone (ms medication) which started a BD flare for me.. Nice one isn't it! I had my blood tested before the Copaxone - no sign of inflammation, then tested again after I stopped it - high ESR and then again after I began the Solumedrol and anti-inflammatory medication - high white cell count & ESR. As my disease was stable before I started all this new medication I was wondering if suppressing the immune system is not actually doing more bad than good.

I see what you mean about the BD being active and showing up in the blood tests. That's probably what's happening to me. So what happens next, do you continue with the immune suppressing medication? Do your blood test results normalize at some point after continuing the medication?

[andreafm]

Hi again Lara

Your questions are really interesting

It seems from what you are saying that the high ESR and the Behcets flare prompted  your consultants to try and get the inflammation down by giving you the solumedrol and anti-inflamatories.

Have you been diagnosed with MS as well as Behcets or are your consultants still undecided ?

The medications your having and behcets itself do play about [through want of a better word] with the blood counts. I guess that your Consultants would be weighing this up in conjunction with the symptoms of the behcets that you are still having.

It might take some time for your symptoms and blood tests to normalise and during that time might even fluctuate. Especially as you was having Copoxone and this might take longer for that to happen. This would be what your consultants are looking for in your blood tests.

I've got to say for me that my blood tests haven't normalized for a long time but this might not be typical of other peoples experiences here. My Behcets has been particularly difficult to manage, but that doesn't mean you would be the same.

I would try and discuss it with your consultants when you see them next. It's good to do this as it helps to build a good rapport with them and helps you to understand what they are doing for you.

We are all very different here despite having the same diagnosis of behcets....hopefully some others here can help you with that question.

[Lara1]

Hi Andrea

I'm not in the UK but I had seen dr. Kidd in 2013 and he diagnosed me as a case of neuro BD. However, in Belgium they said MS hence the Copaxone. And yes, you are right, after stopping the MS medication they gave me solumedrol and anti-inflammatories to try to control the BD flare. At the moment I'm taking colchicine and diclofenac and waiting the next appointment to see if I should take azathioprine as well.

Can you tell me what medication you have tried and what you are currently on?

P.S. since we're talking about my questions.. I have another interesting observation. I was recently pregnant and my white cell count, ESR and other markers of inflammation were well above the upper limit starting from the end of the first semester onwards. Pregnancy is an inflammatory state as the body naturally supresses the immune system. After delivery my blood work went back to normal.. until I took the immune suppressants.