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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suffering From Fatigue, HTN And Diarrhoea. Have High WBC, SED Rate Elevated. Suggestion?

For the last year I have been having WBC with diff done every 3 months due to a high WBC of 19,000. This count has fluctuated throughout the year, but never been normal, also no illness to account for. I do have symptoms of fatigue, petechiae (hands, arms, and chest-occasionally), HTN, and some diarrhea. EKG from 5 years ago normal, LFT normal, CMP normal, Rheumatoid normal, kidneys normal. Been to an allergist and told I do have even more allergies, but would not account for the high WBC. Sed rate slightly elevated. Please advise. Jen
Wed, 20 Feb 2013
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General & Family Physician,  's  Response
Hi and thanks for the question,
Chronic elevation of the WBCs deserves a more critical evaluation. In your case especially, the association with increased ESR, fatigue and petechiae suggest exclusion of a bone marrow malignancy, especially a leukeamia. A bone marrow biopsy might be compelling. Secondly, I would to suggest to carry out Anti nuclear antibodies, HLA27 and antiSm antibodies for your symptoms are also very compatible with systemic lupus erythematosus, which is an autoimmune disease.
the symptoms as I said are very suggestive of a leukemia. An appropriate diagnosis is critical, for the setting up of an appropriate treatment plan. Delayed diagnoses my make the prognosis more faint.
I suggest you book an appointment with the hematologist, to rule out a leukaemia or any possible blood malignancy, and possibly systemic lupus erythematosus.
Thanks for your question and hope this helps,
Luchuo, MD.
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Suffering From Fatigue, HTN And Diarrhoea. Have High WBC, SED Rate Elevated. Suggestion?

Hi and thanks for the question, Chronic elevation of the WBCs deserves a more critical evaluation. In your case especially, the association with increased ESR, fatigue and petechiae suggest exclusion of a bone marrow malignancy, especially a leukeamia. A bone marrow biopsy might be compelling. Secondly, I would to suggest to carry out Anti nuclear antibodies, HLA27 and antiSm antibodies for your symptoms are also very compatible with systemic lupus erythematosus, which is an autoimmune disease. the symptoms as I said are very suggestive of a leukemia. An appropriate diagnosis is critical, for the setting up of an appropriate treatment plan. Delayed diagnoses my make the prognosis more faint. I suggest you book an appointment with the hematologist, to rule out a leukaemia or any possible blood malignancy, and possibly systemic lupus erythematosus. Thanks for your question and hope this helps, Luchuo, MD.