White blood cell count elevated in FBC test. Further test required in 4 weeks

Had routine bloods taken yesterday. No general health problems, but on steroids since July 2018, struggling to get below 10mg and a few PMR flares.

Bloods: HbA1c, cholesterol, inflammatory markers ( always within normal range), B12 (I take a daily prescription supplement as found to be very low a couple of years ago), FBC and thyroid.

GP just phoned to say FBC is only result back and ‘white cell count is elevated”. She wants another test at beginning of June, which I’ve arranged. No other bloods back yet, but in years of FBC taken as routine, it’s never been retested. I’m not unduly concerned; she said infection or inflammation can raise the count. So PMR as inflammatory condition could elevate, I guess, but hadn’t happened before. I know there are more serious underlying conditions which can cause increase. I don’t have infection that I’m aware of. She asked if I could have UTI or a cough. No to both.

So, I’ll wait and see what happens next, but in meantime, is this typical with PMR? And any questions I should ask to better understand the result. Thank you.

[Hidden]

Hi phoenix, my WBC is always elevated and I believe pred can cause it. It depends on by how much its elevated I presume.

[Hidden in reply to Hidden]

Thanks Poop. I’m inclined to think it’s steroid, plus I think I’m out of best control at the moment. Although it was about the same at last blood test, so who knows!

[PMRpro Ambassador]

Raised white count is normal with pred. The neutrophils increase and so raise the total white count. It does usually happen soon after starting pred so that may be why she is wondering.

[Hidden in reply to PMRpro]

But I’ve been on pred for nearly 2 years and three blood checks since starting haven’t shown elevation. So this is new.

[PMRpro Ambassador in reply to Hidden]

Strange. Be interesting to find out if there is anything more behind it.

[Hidden in reply to PMRpro]

Thanks PMR. I’ll update idc. Gut instinct is inflammation running riot, but I want to ask the right questions if necessary. Pain from PMR is bad and I’m struggling to get it under control again. Hey ho😀

[PMRpro Ambassador in reply to Hidden]

BTW - it took me 4 years to get under 10mg!!

[Hidden in reply to PMRpro]

I know; I think my path is similar. I’m less concerned about getting to zero, but keeping symptoms under control is proving a challenge. I’m considering upping to 15mg for a few days to see if it eases pain which I have to admit is getting worse daily. GP wasn’t enthused...but she’s not the one suffering! She wants to send me back to rheumy, but with lockdown, no permanent rheumy it would be months and months before an appointment.

[PMRpro Ambassador in reply to Hidden]

If it is steadily worsening you are definitely on too low a dose

[Koalajane]

My blood test last June showed I had signs of anaemia. Blood test then in October showed this to be okay but B12 was raised. Just had blood test result today and that is now normal so not sure what is going on and reckon it is all to do with steroids

[Hidden in reply to Koalajane]

Thanks KJ. I’m B12 deficient for no apparent reason. Can’t absorb it naturally. Don’t know why and none of risk factors. I think there’s a bit of a link with PMR, but don’t know how.

[PMRpro Ambassador in reply to Hidden]

Pernicious anaemia is another autoimmune disease - have you been checked for it?

[Hidden in reply to PMRpro]

Yes, I believe so. Couple of years back; intrinsic factor test? Think that was to rule out pernicious anaemia and it was fine. Thank you.

[nuigini]

My white blood count has been slightly raised for the six years I've been on prednisone.

[Amkoffee]

I was told by a hematologist that pred increases your white blood count. The reason your doctor is concerned is because that can also be a sign of cancer.

[PMRpro Ambassador in reply to Amkoffee]

It can be a sign of a lot of other things too!!!

[Hidden in reply to PMRpro]

Think I must be on a roll with blood results. I’ve now had three phone calls in less than 24 hours with adverse readings!

B12 is very low, so have to increase prescribed daily supplement. HbA1c is 43 so Dr wants me to ‘have a chat’ with the practice diabetic nurse. I’m well aware of diabetic risks as OH is Type 2, totally controlled via diet for some 15 years. If my reading is elevated, it’s steroid induced and I’ll have to see how I can adjust to reduce the risk/ reading. Only cholesterol to come back with more bad news, but fortunately that won’t happen as ‘due to oversight’, it wasn’t requested! Thank goodness, I’m sure they’ll find more to grumble about.

[PMRpro Ambassador in reply to Hidden]

Lots on the forum have got their Hba1c down while on pred just by drastically cutting carbs - some of us need to cut more than others! But it does work!

I hope they consider B12 injections if you aren't already on them.

[Hidden in reply to PMRpro]

Thanks PMR. I try to keep to low carb as a lifestyle and fortunately ( but not for cholesterol) my food weakness is cheese! I don’t have a sweet tooth. I’ll consider this a warning shot and work at getting things down before next year.

I can’t get B12 shots. She’ll only prescribe the cyclobanin pills. Two a day which previously kept it in normal range. Have a good weekend 😀🍷

[PMRpro Ambassador in reply to Hidden]

If it has worked in the past she has a point I suppose - but if it persists to be low she may have to rethink!

[Hidden in reply to Amkoffee]

Thank you. I know it’s an indicator for many conditions. In 2 yrs of pred, it’s the first elevated reading, so I guess gp is exercising caution.

[TheMoaningViolet]

Hi, my WBC was high at the last test (on 8mg of Prednisolone, 4 months into treatment, 7 months since the onset of PMR) and I had to provide a urine sample to exclude a UTI. My rheumatologist asked me about allergies and this year I do have a noticable hayfever (it is not always the same). She didn't seem particularly concerned about it.