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What Causes Elevated Neutrophil Count?

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Posted on Tue, 24 Mar 2015
Question: Hi - you've answered my questions before so I wanted to come back to you with this. I saw the hematologist/oncologist today for the elevated WBC and neutrophils that I've had for the past 2 years (see my previous question to you). He was very thorough, which I appreciate, however his reaction is freaking me out a little. He did a very thorough history and went back and looked up recent xrays, labs and scans that I've had. He went over my history, system by system, asking me questions and making notes. He did a breast and abdominal exam and looked at moles everywhere. He ordered CBC, CMP and an anemia panel. Also ordered PT, PTT, anti-DPA (?), RA, ANA, LAP and UA with micro and C&S. He also ordered a CT scan of the abdomen and pelvis with contrast. He also talked a lot about a bone marrow biopsy and said if all the labs come back normal, he would definitely do the biopsy. He also said that if I weren't already current on my screening exams (colonoscopy, PAP/PELVIC, mammogram, etc) he would have ordered those as well. I don't know what I was expecting but was a little blown away by the amount of testing for something that I didn't think was all that serious. So my question to you is, is this is standard response to the leukocytosis or does he likely suspect something more serious, as in cancer or leukemia?. He said he just wants to rule the serious stuff out. Should I be concerned or relieved that he is taking this so seriously? I will see him again in 1 week to go over all the results and plan next steps. Thank you for any advise you can give me on this.
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Answered by Dr. Robert Galamaga (18 hours later)
Brief Answer:
Considerations

Detailed Answer:
thanks for sending the question.

I think your doctors being very thorough. I don't necessarily think he suspects you have a particular malignancy but he is trying to rule out all possible causes of the elevated neutrophil count. I agree that it's a laboratory tests are normal and if the imaging studies are normal that a bone marrow biopsy would be reasonable.

there are many different possible causes of elevated white blood cells and in particular elevated neutrophil count and it can sometimes take some time to try to get to the bottom of the actual cause. Sometimes it is due to mild inflammation such as arthritis or autoimmune disorders.

I think the planet your doctor has in place is very reasonable and I would be happy to discuss the results of these studies as they become available.

Sincerely,

Dr. Galamaga
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Robert Galamaga

Oncologist

Practicing since :2002

Answered : 2635 Questions

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What Causes Elevated Neutrophil Count?

Brief Answer: Considerations Detailed Answer: thanks for sending the question. I think your doctors being very thorough. I don't necessarily think he suspects you have a particular malignancy but he is trying to rule out all possible causes of the elevated neutrophil count. I agree that it's a laboratory tests are normal and if the imaging studies are normal that a bone marrow biopsy would be reasonable. there are many different possible causes of elevated white blood cells and in particular elevated neutrophil count and it can sometimes take some time to try to get to the bottom of the actual cause. Sometimes it is due to mild inflammation such as arthritis or autoimmune disorders. I think the planet your doctor has in place is very reasonable and I would be happy to discuss the results of these studies as they become available. Sincerely, Dr. Galamaga