• Welcome to Crohn's Forum, a support group for people with all forms of IBD. While this community is not a substitute for doctor's advice and we cannot treat or diagnose, we find being able to communicate with others who have IBD is invaluable as we navigate our struggles and celebrate our successes. We invite you to join us.

Confused by blood test results

I feel like I am full of nothing but questions lately, but I always come here first to ask because I always get advice from knowledgeable people.

Today I got results from blood work drawn on Tuesday and was a bit surprised by the results. I started flaring in March and started on 40 mg of prednisone (March 10 or so). At that time, my CRP was 53 and my WBC was 12.2. The pred was helping, but I have had trouble trying to taper under 30mg. I am currently at 30mg still, but have had some improvement of symptoms, but not completely. So here were my blood results from this week: CRP was down to 33, but WBC was up to 21.8.

Does anyone have an explanation for the elevated WBC? Should I be concerned? FWIW, I started on 50mg of Imuran on Tuesday and am set to begin Remicade pending test results.
 

Trysha

Moderator
Staff member
Hello Cookie
If that was my WBC I would be quite concerned.
Have you been given the differential count, is the majority of cells nuclear polymorphs,
lymphocytes , are there other types of cells such as eosinophils?
You need to ask the doctors looking after you and if they don't call you then call and ask if you have an infection and should you have further investigations to locate the source of the infection.
They may want to delay further treatments such as Remicade until the possibilty of infection clears up.
Call them .
Feel better soon
Hugs and best wishes
Trysha
 
Thanks for the reply Trysha. I am not sure if a specific breakdown was ordered. Do you know if that is something that can be done retroactively or would that require another draw?

When I spoke with the nurse this morning, she said that my doctor had seen the results and did not raise a concern. I got the impression that he is waiting for the Remicade and Imuran to kick in.
 
The WBC I would be somewhat concerned too. Wait for the results for Remicade just to be sure.

The CRP was confusing me. It was a 53 & now it is a 33? 3.0 or greater is high. My kid is at a 3.71 mg/l which is of concern. When I googled it I see it would be 5.3mg/l which is still high, but can be expected with Crohn's. I wouldn't be in such a rush to reduce the Prednisone until that gets lower. It will just take a bit for the Imuran to kick in. Be as patience as you can be to let the meds start working.

Sending you best wishes. Keep posting if something else changes or comes up too!
 
If I remember correctly, prednisone can elevate WBC as well as glucose. It does work as a great anti inflammatory but it suppresses your immune system. Do you have any signs of infection? It is working to bring your inflammation down.
I would also call doc's office just to make sure all is okay and that you are on the same page. Did your doc's nurse call you and go over results with you? I work as a nurse in a primary care clinic. Personally, I would have called you to go over your plan of care.....any changes in plan and discuss results.....call....you will either be put at ease or you will be able to discuss what do next.
I am out on medical leave and totally frustrated by our medical system. I have been caught as of late with symptoms and no answers and no help from my providers on what to next other than symptom management and me needing to be my own advocate.
Good luck
 

Trysha

Moderator
Staff member
Hello Cookie
It is good that you called the doctor.
If they are not concerned then this might be expected with some meds.
Whenever the lab sees a high WBC a differential is always done, and these days is likely an automated procedure.
I had not realised that the Remicade had already been started.
Feel better soon
Hugs and best wishes
Trysha
 

DustyKat

Super Moderator
The CRP is high but when flaring and not fully controlled is acceptable. My son bounced around these sort figures for most of his pre op period, 3 months.

The white cell count I would be more concerned about as it is indicative of infection somewhere. Prednisone will not treat infection nor will Imuran which will take at least 3 months to become fully therapeutic anyway.

Where is your Crohn’s located?

Is there a chance you have an abscess lurking somewhere?

Dusty. xxx
 
Dusty, My Crohns is in my colon. I have had abscesses in the past (external). I was wondering the same thing. I have a fissure and there is a lot of drainage. Blood and pus or mucus and stool (I tend to have stool leakage when they are soft because I have had two fistula surgeries and weakened sphincter). Sometimes it is hard to tell what is causing what, you know? I am a little concerned about starting the Remicade along with being on Imuran if there is a chance of infection. I don't know if I should push the issue with my GI since he does not seem to be concerned.
 

DustyKat

Super Moderator
I personally would raise your concerns with the GI. You have a right to feel comfortable and informed with any decision you make about your treatment. The GI may well be right about not being concerned but that being the case then there is no reason why he can’t explain it to you and put your mind at ease. :ghug:

Dusty. xxx
 
Top