High white cell count

[elainecleary]

I was diagnosed in June PMR, and put on 15mg preds. which worked straight away. In September due to a chest infection, (I also have COPD.), my GP put me up to 30mg. then down to 20mg. On coming back down to 15mg. I had a massive flare up, so back to 20mg. Recently I had another blood test with a view to coming down again, unfortunately I had an other chest infection so I had to stay on 20mg. (went down to 17.5mg this morning), but the real puzzler was that while the blood test showed good results for the PMR, it also showed a very high white cell count, my GP said he was missing something and booking me for a special blood test next week. Has anyone else had this, or should I assume it's not related to the PMR?

[PMRpro Ambassador]

Pred raises the white cell count but it is possible it is even higher than would happen normally. I'd hope it was higher to deal with an infection too. Did he just do a basic blood count (red cells, total white cells, haemoglobin) or did he ask for a differential count which does a count of all the different sorts of white cells to see which are increased in number? Do you know what the test is he' booked you for next week - I'd always thought that a total white count and differential was normal practice?

I would be a bit inquisitive about the recurrent chest infection - did your GP take a sputum sample for culture when he put you on the antibiotic (I assume he did if you have COPD too)? You could be running a subclinical infection (not enough to cause many symptoms) which your immune system is fighting.

If you have PMR and are on 20mg pred I'd expect the ESR to be low.

[elainecleary in reply to PMRpro]

I don't know the name of the test, but he did say that they look at the white cells under a microscope, so I imagine that they would be looking at the different sorts? Yes I had antibiotics, but he didn't take a culture, mind you It was more of a dry cough and no sputum. He did say that if it came back again, he'd have to do more investigations, but it is not unusual for me to have one after another at this time of the year, I've had COPD for 11 yrs. and also a list of other auto immune conditions. Yes on my last bloods the ESR were low, just had to stay on 20mg for my chest, now this is over and finished the antibiotics on Wednesday, went down to 17.5mg this morning, keeping my fingers crossed.

[PMRpro Ambassador in reply to elainecleary]

Yes - that's a differential white count. You do it by making a think smear of blood on a glass slide and staining it so the different types of white cell can be seen - and then you count them by looking at them under a microscope. It is done by hand/eye, however you want to look at it, and takes quite a bit of time so they usually only do it when it is asked for. In my day I think the lab would have done it for any blood count that was noticeably high. Different illness can change the numbers of various types of white cell so it is quite a useful test.

[Juniperina in reply to PMRpro]

"White cells" = leukosytes? - In my blood tests they were high even before Prednisolon: "fB-Leuk 10.2* E9/l" and 7 months later - after Prednisolon still 9.2* E9/l. Do you use the same counts in your country?

(I'm from Finland.)

[PMRpro Ambassador in reply to Juniperina]

Yes, white cells are leucocytes - 5 different sorts of white cells including monocytes, lymphocytes, neutrophils, eosinophils and basophils. They increase in response to infections - even a cold will do it, as well as other causes. Yes, I think those are the same sort of counts as in the UK - up to about 10 (whatever the units are) is normal.

[Juniperina in reply to PMRpro]

Thank you for the answer!

[JJackdaw]

Hi Elaine, funny that you should post about white cells as only yesterday my gp told me exactly the same thing. I too have to have more blood and a urine test next week, the urine because she said there's some sort of infection going on in my kidneys. I was a little alarmed and was going to post today. Gp also said my esr has risen to so I'm hoping that pmr/pro can shed some light for us. I hope we both have good results from next blood results. Don't worry too much.

[elainecleary in reply to JJackdaw]

Thanks, I also have my share of urinary tract infections. I see from your post time that we probably share the insomnia as well! As the song says "what a drag it is getting older", chin-up, I agree, hope we both get good results, keep me posted.

[Stroppymoo]

Got no infections that I know of, am now worried about cancer of the blood. Am on about 6mg of preds atm