Q. Should I worry about sudden drop in neutrophil and WBC count?
Hi doctor,
I am a 30-year-old woman. I have recently lost a pregnancy at 19 weeks due to membrane rupture. I had induced abortion with Misoprostol two weeks back and there is no complication since. I have had a CBC done almost every week from the starting of my pregnancy and they were all absolutely normal. A month back I had normal complete blood count with WBC 7.5 and neutrophils 5.2. After abortion, I had some trouble being tired and sleepy, hence I have repeated the CBC yesterday. Everything came out the same except for the WBC which is now 4.7 and the neutrophils are 2.28. I have been very stressed out with the abortion experience and I am very much disturbed, depressed, tired and sleepy both during and after the procedure. The obstetrician did not seem concerned, but I was surprised by the drop. I am worried that this drop in neutrophils might be something more worrisome like leukemia. I do not have any fever, flu or cold for many months. I took Propylthiouracil for a few months recently but stopped right before the abortion. I had a urine culture yesterday which is also clear. I have no other symptoms but some pain in the lower abdomen which the doctor said was normal after the abortion. I had a similar neutrophil count three years ago. At that time it was 2.15, so it is not unheard for me. But I am more concerned about the quick drop. Is it something I should be worried about? I feel so tired and overwhelmed by all that happened with the pregnancy.
Kindly help me.
Hi,
Welcome to icliniq.com.
Based on your query, my opinion is as follows:
The WBC count (white blood cell) varies on day-to-day and hourly basis and also depending on variable internal factors. Corticosteroids can affect WBC count, particularly neutrophils. At present, maybe due to stress, which increases corticosteroids in the body, which further has probably affected the neutrophil count could be the cause. Neutrophils have a short life span of less than a day in the blood, from where they move into tissues and get destroyed. They are produced as necessary, and until the count is normal, not to be worried.
Regarding leukemia, the count is usually elevated and maybe more than 100 and very rarely it is reduced. However, when reduced, all the cell lines are affected resulting in very low hemoglobin, platelet count, resulting in bleeding and low WBC count presenting with infections, etc. At present, you are completely healthy with all cell parameters in blood within the normal range. There are no abnormal cells in the blood, which virtually rules out leukemia.
At present, the counts may be reduced secondary to stress induced corticosteroids influence. The bone marrow is functioning well and your body is responding well physiologically and nothing is there to be worried about. The tiredness is due to recent physical and mental stress and as you get back to routine activity, it will improve.
Treatment plan:
No treatment necessary. Continue with regular schedule.
Preventive measures:Relaxation.
Regarding follow up:For further information consult a hematologist.
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