White cell count and neutrophils low on MTX

[Circledancer]

Hi, I have a diagnosis of sero neg RA and have been taking mtx for almost 5 years with HCQ added 3 years ago. I've had the occasional repeat blood tests requested at gp surgery for liver results over these years, but its always been a blip and gone back to within range quickly. I had regular monthly bloods done last Monday and got a call from the pharmacist at the surgery on Thursday saying that my white cell count and neutrophils were low and I've not to take my mtx on Monday and that they've contacted Rheumatology at the hospital for advice. Has anyone else come across this and is it serious? 😕

[gailboddy]

Happens to me most months .. Neutrophils around 1.3 and WBC around 4 .. I also have to miss injections occasionally ... Consultant doesn't seem bothered though!

[Circledancer in reply to gailboddy]

Thanks for your reply. My neutrophils are 1.6 and wbc 3.4. I realise that it can make you more prone to infections, but do you know if there is there anything else I should look out for or can do to make it better?

[gailboddy in reply to Circledancer]

You cant really do much but miss or lower dose of Methotrexate .. I would say speak to GP/Consultant .. My Consultant lowered my dose of Metoject to 10mg from 20mg but still have low readings!! His last letter said if I get any infections he may stop it all together and just have Benapali

[Sunshinereturns]

I am so sorry, this happened to me and I was devastated as my treatment was working and hasn’t fully settled since. My advice is checking that it’s the methotrexate that is causing it. They made me drop my methotrexate dose (a flare ensued soon after) when it was the accompanying sulfasalazine I was on that was causing the problem. I no longer take sulfasalazine but was put back onto highest dose methotrexate and my bloods returned to acceptable levels.

[Circledancer in reply to Sunshinereturns]

Thanks for your reply. How did they find out that it was the Sulf which caused it?

[Gilliancheche]

I have low neutrophils and white cells too. After repeated blood tests when I started MTX my consultant decided that she was happy to continue as they plateaued. As long as I don't suffer from repeated infections, which I don't, she says that is obviously ok for me. If my neutrophils drop below 1 then they ask me to skip a week, this has only happened a couple of times.

[NormaY]

hi yes I had this when on MTX

[mld78]

hi. I was on both Sulfasalazine and methotrexate. A year ago the Sulfasalazine was stopped in an attempt to increase my neutrophils and WBCs. Didn’t work! Now they’ve stopped my Methotrexate. Both sets of blood tests are still way too low. Everyone is having a think about what is happening, but some consultants are suggesting something else is going on so I’m having test after test after test!

I really hope your bloods return to normal.

[14bubbles]

My neutrophils and WBC are sometimes a little low when I have my blood tests, first time GP told me to stop MTX til they'd spoke to the hospital...ended up having to chase this as never heard back from GP, hospital were happy for me to try again with MTX, now they just seem to drop occasionally but GP and hospital don't seem worried by it and they usually pick up again.