Luckily, my rheumatologist was one I saw while in the hospital. She listened, explained, and answered questions. She is treating me for GSA even though my biopsy was negative. I am currently on 40 mg of prednisone. I am still very fatigued, legs are heavy and weak, arms weak, some pain in right temple. Rheumatologist is keeping me on 40 mg of prednisone and adding methotrexate. I have a follow-up in 4 weeks.
I have a question regarding the blood test results taken on May 16. My CRP(less than 3) and sedimentation rate (19) are within normal ranges. However, my lymphocytes are low (.61) and neutrophil high (8.57). From what I have read, this shows severe inflammation. I will discuss this with rheumatologist at 4 week follow-up, but I was wondering if anyone has any insight/understanding into this.
As always, I am thankful for your thoughts, advice, and understanding. I purchased the book recommended on this forum on how to live with PMR and GSA.
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Moaningxcat
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Thank you very much for the link you flagged up as my ratio of Neutrophils to Lymphocytes came to 6.71 (9.4 Neuts divided by 1.4 Lymp.) which would seem consistent with the inflammation caused by PMR. Lots of conditions listed but not PMR though. On my test results they have headed these things up under Differential and Awaiting Doctor's comments, so I will hear more on Friday when I see the GP.
Luckily he has been very impressed with what I have shown him from our forum so far. I asked about Steroid sparing medication/programmes and he just said he had no knowledge of either of them. My 10 mins may have been up when I asked of course!
Hope it was - because he SHOULD be aware, even if he can't initiate them he will have to monitor them! But I suspect he didn't feel qualified to discuss them.
My wbc and neutrophils have almost always been flagged as high, rhuemy and GP always say because of prednisone? But esr and crp always for years been in normal range, now RBC flagged as low, under norm by a fraction, read that some autoimmune condition can cause that result
Thanks for sharing your results. My latest blood test revealed lymphocyte of .61 and neutrophil of 8.57 so NLR ratio is 14. That worried me so I was curious what other people on the forum have experienced. As I mentioned, I am on 40 mg of prednisone and my CRP and sedimentation levels were within normal range.
Well I have tapeted now from 40 mgs dec 2022 to 4 mgs, long time still show wbc high and neutrophils high inflammation markers still elwithin normal range,
On May 2, 2023, my neutrophils were 85.1%. My lymphocytes were 8.4%. Clearly, I have major inflammation and PMR is most likely the culprit. Pain in shoulders worsened when on 4 1/2 mg Pred. Today I took 6 mg. I will look further into this, because the increase may not be enough to wipe out the inflammation.
I am glad others have commented on neutrophil and lymphocyte numbers because I have been wondering whether the cause was PMR or some other condition.
I have watched those number rise and fall with my GCA, Pred and Actemra...I appreciated you initiating the discussion. I'm so glad your doctor is keeping you at 40mg...we only get so many chances with our sight and I'm glad she is being coservative and safe. To me, it says a lot that she is seeing you in four weeks. Take it easy now...although I'm sure you don't feel like running a race....you will feel better.💞
Thank you for sharing and for your encouragement. Sometimes I wonder if I will ever feel close to how I felt before the GCA. It’s surprising how long it takes…
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Update: Finally
I am new here. How long did you stay on 10 mg of prednisone?
New guy, PMR uncertainty 
