Q. Can fluctuating blood pressure cause elevated WBC?

Answered by
Dr. Nagaraj
and medically reviewed by Dr. Hemalatha
This is a premium question & answer published on Jan 08, 2020

Hi doctor,

Can fluctuate blood pressure cause elevated WBC? I got sick with chronic idiopathic urticaria and started MTX. My Rheumatologist diagnosed me with seronegative RA and stopped MTX. Did Vectra DA test, and scored 42/moderate for RA disease. I was supposed to start Remicade this Thursday, but my blood pressure started fluctuating as high as 189/108 mmHg to 138/83 mmHg with low HR as low as 43 at rest. In ER, they checked heart, lungs, and kidneys. They referred me to a Cardiologist, and she added a new medicine Edarbi 40 mg, but said WBC is 20.11, with polys 93.1 and lymph 3.5.

I was referred to a Hematologist. He said that it looks to be some bone marrow abnormalities and suggested more extensive blood tests to see if reactive effect to inflammation or blood disease or cancer. The other symptoms are weakness, fatigue, and intermittent slight shortness of breath, but I suspected all was due to pressure or heart rate issue. Fever, chills and body ache lasted for one day. I was fine after I took 500 mg Naproxen. There is no cold symptom with fever. I saw my Rheumatologist, and she said it is not RA related based on high polys. CRP ranged from 7.2 to 17.6 earlier that is before two years, and now almost at its lowest at 8. Does this look like a body reacting to inflammation or pressure or heart rate? Also, I have intermittent pain in lower left abdominal area. I do not see my Hematologist for follow up until next month and cannot start Remicade until I get it figured out.



Welcome to

Thank you for providing a detailed history.

To answer your first query, there is no direct correlation between fluctuating BP and the increase in cell counts.

CRP is usually elevated in RA (rheumatoid arthritis) disease, which is a common finding reflecting the body's reaction to inflammatory or autoimmune disorders like RA.

Though your BP is now controlled to some extent, the low pulse rate could be because of Bystolic 5 mg (Nebivolol). You need a review with your Cardiologist for the same.

Also, looking at your non-specific symptoms like weakness, fatigue, intermittent shortness of breath, fever, chills along with elevated differential white cell counts, it is advisable to have bone marrow examination done to rule out hematological malignancy.

I am not convinced with your RR of 98. Have you checked it correctly? Please update. Thank you.

Investigations to be done:

Bone marrow aspiration.

Regarding follow up:

Review with Cardiologist and Hematologist.

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