Advice re consistently high white blood cell count

[Fatsiajaponica]

I have a telephone consult tomorrow with GP (his initiative) and would like to be prepared! Not the best GP in terms of forming partnerships with patients.

From just prior to steroid prescription awaiting diagnosis of PMR , to high steroid meds (between 60 and currently 20mgs) my WBC count has been very high, one nearly off the scale. I understand that it may have been PMR and /or steroids which have done this. Any thoughts? I have no temperature or indications of infection aside from possibly a tooth issue which will be assessed later this month. May be a 'how long is a piece of string' question as aware it could be many things and further investigation may be required, however, if GP decides it's the steroids, need to be prepared as am going slow following a mini flare.

[Fatsiajaponica]

Now that's a lesson to look properly at related posts, all the information is there from ones who know. Apologies for wasting your time.

[DorsetLady PMRGCAuk volunteer in reply to Fatsiajaponica]

No problem - unless you do a search beforehand [and that’s not always as productive as it should /could be] - you have to post a question before you get a list of related ones! 😊

[SnazzyD]

Pred increases the Neutrophil count which will make the overall white cell count greater. High doses certainly put mine up. It can make it tricky to spot an infection but lack of symptoms helps.

[PMRpro Ambassador]

How high IS your WBC count? And what is your differential count - do you know?

[Fatsiajaponica in reply to PMRpro]

Total White cell count - 16.2 - last month, in August 24.1 shown on a scale nearly off the chart but improved, I think with the lowering of the steroids.

Neutrophil - now 14.22 was 21.5 so also improving

Lymphocite etc.. in normal range.

[AyJayBass]

I had high WBC, Neutrophil and Monocyte count for some time. It didn't cause me any concern as I attributed it to Pred. My GP decided it was worth a referral, especially the Monocyte a count and I have now been diagnosed with CMML - Chronic myelomonocytic leukaemia. I believe the high Monocyte count is the primary indicator.

leukaemiacare.org.uk/suppor...

[PMRpro Ambassador in reply to AyJayBass]

Sorry to hear that - hope they are able to manage it well for you.

[AyJayBass in reply to PMRpro]

It's watchful waiting at the moment with checks on Bloods every 3 to 4 months. If it goes Acute then treatment will be required. It can stay Chronic for years so at the age of 81 I may well escape this!!

[PMRpro Ambassador in reply to AyJayBass]

Otherwise known as Masterly Inactivity! You may well indeed - do hope so. I never think of you being over 80!!!!

[AyJayBass in reply to PMRpro]

Well I'm not entirely decrepit yet! Just fading a bit physically due to fatigue and muscle wastage. The primary effect of CMML is fatigue so I am on a double whammy there. I have been following my Rheumy's tapering plan since August 2023. I was on 8 mg then and got to 5mg after a year, at 1 mg every 4 months. It has been going well so I am sticking to it, if anything I am going even more slowly.

[Fatsiajaponica in reply to AyJayBass]

Ah, yes, it is perhaps too easy to blame everything on pred. Often here we are warned that something else could be going on. I hope that this is managed well for you. Best wishes and thank you for your reply, I will check my results again. 💐