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Q. Is high WBC without infection worrisome?

Answered by
Dr. Prakash H. Muddegowda
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Nov 02, 2015 and last reviewed on: Sep 19, 2018

Hi doctor,

I am a 29 year old female. I am overweight. My regular doctor noticed my WBC has been high every single time he has drawn my blood. He even asked me to come back several times to double check. It has been like this and climbing slowly for a year. He referred me to an oncologist. But in the mean time, I am going crazy on what could this be.

I am scared and unsure of what I can expect. I understand that everyone is a different case. But I am curious as to if this is something small or potentially something life changing. Following details are from my last draw, WBC count 15 on a 10 scale, MCV 77, MCH 24, RDW 16.2, neutrophils 10.1 and lymphs 3.8.

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#

Hi,

Welcome to icliniq.com.

Based on your query and report (attachment removed to protect patient identity), my opinion is as follows:

A rising WBC (white blood cell) count in the absence of any infection, however mild is sometimes worrisome and that is being at present felt by your doctor. Mild increase in neutrophil is present. I assume there is nothing abnormal in the peripheral smear. Peripheral smear is most important here to confirm the absence of any immature cells.

Rising count sometimes signifies leukemia. However, in leukemia, the count is usually more than 100000 or less than 4000 on a 10000 scale. The absence of any immature cells virtually rules out any leukemia. Possible causes here could be stress; lipid abnormalities induced inflammation in blood vessels or liver (over weight) or mild infection somewhere, which is currently asymptomatic.

Reduced MCV (mean corpuscular value) and MCH (mean corpuscular hemoglobin) indicate possibly early iron deficiency anemia. Iron studies can confirm or start of treatment with Ferrous Fumarate daily will help.

If anemia is present with rising WBC count, a chronic inflammation cause will require evaluation. C-reactive protein levels and ESR (erythrocyte sedimentation rate) can help in the evaluation of chronic inflammation if any.Do get a C-reactive protein, ESR study and iron studies done. Nothing worrisome at present. If not sure, attach your whole report as a PDF for better opinion.

Revert back with your new report and PDF to a hematologist online --> https://www.icliniq.com/ask-a-doctor-online/hematologist


Thank you doctor,

I knew that I have had iron tests before and have been told I am not poor in iron. But I do not have the results for some reason. I am attaching the last report, as it is most current just to double check. I do not have any pain or symptoms of sickness and this has been ongoing for what I thought was a year but dates back to 2006.

#

Hi

Welcome back to icliniq.com.

After going through the reports (attachment removed to protect patient identity), my opinion is as follows:

Raised RDW (red cell distribution width) with low MCV and MCH definitely should be the features of early iron deficiency anemia. If not now, may be in another two to three months, you may develop iron deficiency. Correction at present is necessary. If iron studies are normal, chronic anemia, secondary to chronic inflammation can be thought of.

Early diabetes signs are present as indicated by raised HbA1C (glycated hemoglobin) pre-diabetic. Overweight could be contributing to glucose intolerance. Diabetes is a metabolic stressful condition, which could be reflected in the values. Diabetes can lead on a mild chronic inflammatory disease.

Both the cell lines are increased (neutrophil and eosinophil), indicating an overall increase. No possibility of any leukemia as no single cell line is increased and also no immature cells are seen. The count could return to normal with good control of diabetes, specifically in this early stage through diet, weight reduction, stress and sleep management. ESR and C-reactive protein are not done, which could be raised. Abnormal HbA1C could be the cause. If controlled, the levels will return to normal.


Treatment plan:

1. Iron supplements.
2. Weight reduction.
3. Diet control.

Preventive measures:

Early stages, overt diabetes can be delayed or avoided.

Regarding follow up:

Revert back after HbA1C returns to normal to a hematologist online.---> https://www.icliniq.com/ask-a-doctor-online/hematologist


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