I’m pretty new to RA and have been on methotrexate for about two months now. I’m also taking 5mg of Prednisone, until the methotrexate kicks in (so the nurse said). I’m currently having blood tests every two weeks and last week the consultant phoned me to say my white blood cells were very high. He asked if I had an infection of any kind, which I don’t. When I spoke to the nurse a few days later, she said that steroids can raise the White blood cells. But now I’m confused as isn’t that supposed to lower inflammation??? Still trying to get my head around all the info so please bear with me if it’s a silly question 😳😳
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Kati66
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White blood cells are produced by your immune system to fight infection. They aren’t a marker for inflammation as far as I’m aware but I could be wrong. So it means your immune system was fighting some sort of infection or virus. If they’ve gone back down to normal on your next blood test then you probably had a cold. I hope the mtx starts to work soon 😊
Prednisolone can increase wbc, especially neutrophils in early weeks of treatment. They should be able work out if that’s the case or if infection. I know my neutrophil count was higher than usual and it was flagged as”expected” when I started on pred. Maybe they are being cautious if the count has been fine previously?
All good wishes -hope the mtx works well. It’s made a great difference to me .
Morning. If you are having injections your cells may see this as a ‘muscle injury’ and move to repair which increases WBC. I had this after my flu & Covid jabs last autumn/winter. They resumed normal levels a couple of weeks after.
Not to alarm you but I had that phone call too...."you're white cells are high, have you got an infection" me no I feel fantastic (I'd just started a biologic and felt amazing, the feeling lasted a week). Few days later developed a pain in my side, thought had pulled a muscle,( I wasn't exactly exercising so not sure how), month later turns out I had pneumonia. They will be monitoring and if the white cells go down you've fought off the infection, otherwise if you notice anything a bit odd compared to normal let them know.
I’ve been on prednisolone for years and my white cell count always sits at the top or just out of range. I’m also on MTX and a biologic. It’s my leucocytes that get affected, with levels below the bottom of range. WCC does not correlate with inflammation, my inflammatory markers are always normal. The other thing is steroids can mask symptoms, so you may havd had a viral infection and been unaware. I have chronic wounds on my leg, the only thing that told me they were infected was an increase in pain. The nurses were skeptical, as it wasn’t red and hot, but swabs confirmed I had a nasty pseudomonas infection. I wouldn’t worry to much about it.
Hello Kati, there is so much to know when you are diagnosed with RA and there is a lot of conflicting information on Google etc.
One place to get good and reliable information is NRAS UK. Have a look on their website. You'll probably find the answers to many questions. They also have a tool called SMILE-RA. A series of module which are really helpful for newly diagnosed people. I wish you all the best.
Hi Kati66 some people, not everyone,can have an infection without knowing, eg uti. This would put your markers up a bit, but some people's markers can be slightly raised anyway. Its not a daft question, it is confusing when you are first told of your diagnosis and you are right to ask questions. We promise you we are a friendly bunch and don't bite!😊
thank you, I’ve found this group to be very helpful and like you say, there’s so much to take on board with initial diagnosis. I can see why some want RA to be known as Rheumatoid Disease as it’s so much more than Arthritis!!
I was diagnosed a year ago and had the same medication plus steriod injections as the pain was really great. It took around 9 months for the pain to subside but wanted you to know it will, and you will hopefully be able to live a near normal life again. All best wishes
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A call from my doctors today....
Need some educating please
Nurse delayed methotrexate 
Is anyone taking sulfasalazine?
Methotrexate and a cold 
