Why is my neutrophil number dropping?

Question

Hi doctor,

I recently had my blood tests done for unexplained bruising, mouth sores, muscle pain, and headaches. The neutrophil number came back as low as 1.2. I looked back at my past laboratory results and the neutrophil number has been dropping as follows. First, it was 3.4, then 3.2, 2.9, 2.7, 2.1, and now 1.2. Could this be a sign of something more serious? I take Enbrel for psoriatic arthritis and also, my immune system is low.

Answer 1

Hi,

Welcome to icliniq.com.

Based on your query, my opinion is as follows:

If the immune system were being affected, then I would like to look at the whole picture of WBC count (white blood cell) and decide.
Psoriatic arthritis is a chronic disease and in chronic diseases, the lymphocytes increase. When the counts are being done, the count is usually done for 100 cells.
If lymphocytes increase, the neutrophils will reduce and if the neutrophils increase, the lymphocytes will reduce. As you have psoriatic arthritis, other WBC would have increased and hence neutrophils is appearing low.
Unexplained bruising is probably related to platelet count. If the platelet count is normal, then it could be a complication of psoriatic arthritis on blood vessels.
The muscle pain and headaches could be due to psoriatic arthritis. The mouth sores could be due to side effects of Etanercept.
If the immune system were to be affected, both lymphocytes and neutrophils would be reduced or the whole WBC count and if there was bone marrow suppression, all cells including RBC and platelets would be affected.
At present, as the lymphocytes are increased, the neutrophils appear to be reduced. The symptoms are more of a side effect of psoriatic arthritis and its treatment. Nothing serious related to neutrophils. Not to be worried.