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Have fluctuating wbc level. Blood test, urine test and chest x-ray normal. Underlying cause?

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General Surgeon
Practicing since : 2008
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Any ideas on what could be causing a WBC of 31.7, back down to 6 three days later then up to 20.6 two days afte that? Blood cultures negative, urine negative, chest X-ray negative, nothing showing on the abdominal ultrasound, thyroid is good, GGT at 45, neutophils at 29
Posted Mon, 25 Mar 2013 in X-ray, Lab tests and Scans
Answered by Dr. Grzegorz Stanko 29 minutes later

Thank you for the query.

Such WBC levels can appear due to infection (however it seems to be ruled out) or due to cancer. Sometimes pregnancy or physical activity can cause elevated WBC level. If you have not have any physical activity recently you should keep looking.
I suggest you to have checked CRP, procalcitonin (both will be elevated in infection), CA-125 (ovarian cancer marker), CA19-9 (gastrointestinal cancer marker). You should also visit gynecologist and have transvaginal ultrasound (abdominal ultrasound wont tell anything about ovaries or uterine), breast examination (you can do it by your own), breasts ultrasound.
If still no findings, you should visit hematologist.

Hope this will help. Feel free to ask further questions.
Above answer was peer-reviewed by
Follow-up: Have fluctuating wbc level. Blood test, urine test and chest x-ray normal. Underlying cause? 29 minutes later
Wouldn't the blood cultures show any abnormal cells? My CRP was up to 38.9
Answered by Dr. Grzegorz Stanko 16 minutes later

Blood culture would show only blasts cells characteristic for leukemia. For other cancer WBC elevation will be the only indication in blood culture.
Your CRP (should be like 200 -300 with acute infection) is quite low what rather rules out the infection.

Above answer was peer-reviewed by
Follow-up: Have fluctuating wbc level. Blood test, urine test and chest x-ray normal. Underlying cause? 5 minutes later
If it was a type of cancer, shouldn't the WBC be high all the time? It went down that one time
Answered by Dr. Grzegorz Stanko 11 minutes later
Well, immunologic system is very unpredictable for us as we do not know most of the processes responsible for its working. Its because immune system is so complicated.
You do have two high WBC results and one in normal range. It is possible that the low one is just a laboratory mistake (blood cells are counted by computer without human verification, that is why mistakes are not so rare).
The other possibility is that something in your body stimulates your immune system cyclically so WBC do rise and than drop down than rise again. It can be due to some cells (cancer or bacterial) are exhaled to the blood stream periodically.
It also happens that due to long lasting infection (or other stimulation), WBC are getting used up and there is nothing left so its level decreases.
All this is just a theoretical consideration and can have nothing in common with your condition.
I do not tell that you have a cancer. Just wanted to point that you should rule the cancer out. It may happen that you wont never find the reason of such WBC results.

Hope this will help.
Above answer was peer-reviewed by
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