What causes low WBC, neutrophils and high eosinophil count?

Question

Hello doctor,

First of all, I feel just fine. I have no issues with infections and cold. I cannot recall the last time when I was sick. I do have allergy-induced asthma and I take Advair and Flunisolide. I had a CBC recently and all values were normal except for WBC which is 3.9. My PCP ordered a repeat CBC with the differential count. This time my WBC is 3.2

Absolute neutrophils 1.54 (reference 1.8 to 7.7).
Absolute lymphocytes 1.05 (reference 1.2 to 3.2).
Eosinophil 10.8 (reference 0 to 3).
Monocytes 8.4 (reference 0 to 8).

My nRBC's were 0, immature neutrophils and absolute neutrophils low end of normal. For the past eight years, my WBC's were fine but 9 to 10 years ago they were 3.9 and 3.5. Your advice is appreciated.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern. The absolute neutrophil count is slightly low as per the provided report. Temporary associated viral infection along with allergic inflammation can lead to low neutrophil count. Her main concern is high eosinophil count.

Normally, if allergic inflammation is under control then the eosinophil count is not high. You are taking steroid nasal spray and Salmeterol plus steroid combination inhaler. But as eosinophils are high you can be prescribed Montelukast plus Fexofenedine combination drug as an antiallergic medication for seven to ten days.

Asthma confirmation and severity can be assessed by spirometry investigation. You can investigate with allergy testing to know the allergen that leads provocation of an asthma attack.

Repeat CBC after one week of taking antiallergic medication. Consult a pulmonologist for examination and spirometry and discuss my answer with him.

I hope this helps.