Q. What can cause low WBC count?
Hi doctor,
My father-in-law is 58 years old. He had a stroke a year back and has been diagnosed with non-critical CAD. Within a period of two months, his WBC count has reduced from a range of 7.5 to 2.8. But, there is no sign of infection. The overall count of ANC is more than 1000 and platelets are 140. We consulted a doctor and he has advised us to take a few multivitamins and keep a weekly check on the count. How should we proceed further? Please guide.
Hi,
Welcome to icliniq.com.
Based on your query, my findings are as follows.
- Your dad is suffering from macrocytic anemia along with leukopenia (low-level WBC) and pancytopenia (deficiency of RBC, WBC, and platelet).
- There is only a slight decrease in the number of platelets, so you need not worry.
- Megaloblastic anemia can occur secondarily due to vitamin B12 and folic acid deficiency.
- It is advisable to take multivitamins that are vitamin B12 and folic acid supplements. Improvement in counts will be gradual and may take up to two months.
- The reticulocyte count if increased within a period of 15 days can yield a good outcome. If there is no rise in the reticulocyte count, then vitamin B12 and folic acid serum assay will be necessary to rule out any malabsorption.
- The erythrocyte sedimentation rate (ESR) is normal and there are no abnormalities found in any of the cell lineages.
The Probable causes:
The probable causes are vitamin B12 and folic acid deficiency.
Investigations to be done:1. Reticulocyte count. It has to get repeated after 15 days to check if there is any rise in number.
2. Vitamin B12 and folic acid assay.
Megaloblastic anemia.
Preventive measures:Improve your nutrition by having eggs, chicken, red meat, pulses and green leafy vegetables.
Regarding follow up:Revert back with the investigation reports.
Thank you doctor,
His vitamin B12 and folic acid tests are done but there was nothing deficient. I have attached the previous reports for your information. We are very much worried as this seems to be serious. Our cardiologist has advised us to keep a check and see if there is any improvement within a month and get the blood test done on a weekly interval. Please suggest us what can we expect from the outcome since we are very concerned.
Hi,
Welcome back to icliniq.com.
- In your dad's case, cause is not related to nutrition. Other causes at the level of bone marrow need to be evaluated.
- Please answer few questions for detailed information. Did he undergo any bone marrow biopsy recently?
- Is there any rise in the reticulocyte count? As Increase in this count will help in good functioning of the bone marrow.
- Since few drugs can suppress the bone marrow, have you been taking any new medications for the past one year?
- Do kindly discuss with your doctor regarding the above tests and find a way to get to the cause. Till the main cause is identified take the drugs prescribed earlier.
Revert back with the detailed reports to a hematologist online --> https://www.icliniq.com/ask-a-doctor-online/hematologist
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