Leukocytosis: To Panic or Not To Panic, that is the question
January 5, 2006 8:22 AM   Subscribe

Leukocytosis: Anyone have any experience with it...and it didn't turn out to be something scary?

For the second year running, when I've had my annual physical, my white blood cell count has been significantly above normal. (A third again higher than the highest range of normal.) My doctor doesn't seem to be terribly concerned, but of course the google infused hypochondriac in me is convinced it's something horrible. (Because, I'm like that...what can I say.) Has anyone had experience with significant elevation in WBC for prolonged periods? What tests did your doctors order? Ideas as to what could cause it if there doesn't seem to be a trigger? It seems to me that there should be a test that could figure out *why*, but I could just be being silly.
posted by dejah420 to Health & Fitness (11 answers total)
 
How's the count ? and for how long it was at high rates ?

you know little cold can rise your WBC count, so for most of the times there's nothing to be afraid of.
posted by zouhair at 8:32 AM on January 5, 2006


Response by poster: 16.5 this year. 16.3 last year. And yeah, I do have a cold/flu now, so I was probably on the front end of it when I got blood drawn. It's the two years in a row thing that has me a little concerned.
posted by dejah420 at 8:42 AM on January 5, 2006


to get sure of it, you can ask your doctor to repeat the test away from any kind of stress (it can rise WBC count too) or infection.

And I'm sure everything could be Ok

The really big counts is more than 20 and some other clinical signs of some blood diseases. If your doctor didn't seemed concerned is because you should'nt have any clinical sign that can be a problem.
posted by zouhair at 8:46 AM on January 5, 2006


I used to work in a hematology lab...years ago...

Does the lab report break it down to lymphs & neutrophils? Lymphs fight viruses, neutrophils fight bacteria. Then we could look at if you had a cold, recent wound, etc.

On the one hand, I agree it's probably nothing to worry about, but I also think your doctor should have taken more curiosity in the matter.

Also, was the test done in the doctor's office, or did he/she send it out? (If it was done in the office, they probably got the results back while you were still there.) Physician-operated labs are notorious for poor quality control.
posted by Brian James at 11:53 AM on January 5, 2006


Response by poster: I haven't read the lab report, so I don't know if it broke things down. The test was done by an independent lab, it took a couple of days for results. (And left a nasty bruise this time. All purple and green...bleh.) His office called a little while ago and said that the doctor does want me to have more blood drawn when I finally lose the flu symptoms.

I don't know anything about hematology at all, so perhaps he ordered some sort of general test first, that doesn't break things down, and now he wants a specialized test...or do all tests have the break down info and he's just doing verification?
posted by dejah420 at 12:16 PM on January 5, 2006


Just about all modern machines can break the WBC count down into lymphs/neutrophils. So he probably is going to run the same test when you're over the flu, which I think is the correct thing to do to verify the results.

I forgot to mention that smokers have higher WBC counts...do you smoke regularly, dejah420?
posted by Brian James at 12:35 PM on January 5, 2006


Best answer: i have leukocytosis...or had leukocytosis. for the past 7-8 years my WBC has been abnormally elevated. my differential count (% sub-populations of various WBCs) has been normal. my RBC and platelet counts and my hematocrit and hemoglobin have also been in the normal range. throughout this period of time i felt completely normal without any symptoms.
at first my white counts were slightly elevated, like in the 13-13.5 range. after a few years of this my doctor sent me along to hematology/oncolgy, as a just in case. that visit was unremarkable. the hematologist did run a special blood test called LAP (leukocyte alkaline phosphatase), which was only slightly elevated and of no concern.
since then, my whites had continued to climb into the 15-17 range. about six months ago the count was 20. while i felt fine i always had this nagging feeling that something could be wrong. my doctor varied with concern, from sending me to hematology to totally dismissing the high counts altogether. he did follow my bloodwork every 4 months throughout this 7-8 year period.
then suddenly, about 3 months ago, i finally got a normal WBC of 9. this was the first WBC in the normal range for 7-8 years, that i know of.
over the years i have been reading alot about blood and blood counts and learned alot. first off, normal ranges are based on 95% confidence interval, which i think means 5% of the population will be outside the normal range, 2.5% above (us) and 2.5% below. smoking can increase your WBC, but so can stress and exercise and certain medications. i smoke moderately, less than a pack a day. i decided to forego smoking before the last blood draw and that is when i had my normal count. to retest my hypothesis, i didn't smoke yesterday before i had my blood draw. i will wait and see what the result is, but i'm betting it's all related to smoking, at least for me.
bottom line, i feel fine, i'm being followed closely and i should stop smoking.
posted by brandz at 4:50 PM on January 5, 2006 [1 favorite]


16k is not much of an elevation. If the differential (the proportions of the various subtypes of white cells) is normal, I would forget about it.
posted by neuron at 5:28 PM on January 5, 2006


Response by poster: Smoking, eh? Hmmm. I've pretty much quit, but the test was only a few days after I stopped.

Thanks for all the advice, and thanks for sharing your story brandz. I feel much less panicky now.

Hugs all around!
posted by dejah420 at 5:34 PM on January 5, 2006


Leukocytosis is also associated with stress in animals. (The classic "stress leukogram", which is elevated neutrophils, mostly.) IANAD, but I am a vet.

Afraid of needles/don't like the squeezy feeling of the tourniquet/white coat hypertension/icky doctor? All those might contribute as well.
posted by marmot at 12:23 PM on January 6, 2006


Response by poster: I've donated so much blood to blood drives over the years that all the squeezy band and white coat does is make me want a cookie. ;)
posted by dejah420 at 2:34 PM on January 9, 2006


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