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    Is elevated WBC in cerebrospinal fluid a cause for concern?

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Posted on Thu, 2 Jun 2016 in General Health
Question: I experienced urinary retention with no other symptoms. I had a lumbar puncture shortly after that showed elevated WBC (71, mainly lymphocytes). All other results normal and viral culture showed nothing. The urinary retention has since stopped and I now have no symptoms. MRI of brain and spine are normal. Is the elevated WBC in the cerebrospinal fluid a major cause for concern?
doctor
Answered by Dr. Olsi Taka 34 minutes later
Brief Answer:
Not a major cause for concern.

Detailed Answer:
I read your question carefully and I understand your concern.

It seems that your doctors have done the necessary tests in front of your symptoms, your evaluation seems to have been thorough.

There are described cases in literature of transient urinary retention with a high lymphocyte count like in your case. It is thought to be a form of benign infection involving spinal cord and nerve roots, more probably to a unknown virus, another virus than those tested in common cultures. The prognosis of these cases is good as the fact that you are symptom free now suggests.

So the answer to your question is no, given the present lack of symptoms, normal MRIs and other normal tests I do not believe it should be a source of major concern.

Let me know if I can further assist you.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Olsi Taka 10 minutes later
The Neurologist diagnosed a mild Guillain Barre variant. Do you recommend a second option or a repeat lumbar puncture? From what i see its almost unheard of to have Guillain Barre with normal protein and elevated WBC.
doctor
Answered by Dr. Olsi Taka 11 minutes later
Brief Answer:
Read below.

Detailed Answer:
I do not agree much with that diagnosis. As you say lumbar puncture doesn't correspond and urinary retention is not the most common symptom of Guillain Barre, not an isolated one at least.

You could have a second opinion but I wonder what could that bring to the table since everything has resulted normal, perhaps you could do that if any new symptom appears. As for other possible tests I would consider oligoclonal bands for multiple sclerosis (not that I think it likely with a normal MRI, urinary retention is not the typical first presentation either).

I wouldn't have repeat lumbar puncture if you have no other symptoms, would advise to wait and see frankly.

I remain at your disposal for other questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Olsi Taka 11 minutes later
It seems they ran me thru a lot of testing. Probably as many as they could think of. I have a stack of test results. Its there another name for this banding test? Gram stain perhaps? It may have been done already. The Dr seemed to think MS was unlikely but maybe that was just based on the 2 MRIs being clear. The only other symptom was skin burning in pelvis/feet and fever. Also symptoms of a UTI. This was very short term and a day or so before retention .
doctor
Answered by Dr. Olsi Taka 8 minutes later
Brief Answer:
Read below.

Detailed Answer:
No it is not called Gram stain (gram stain is done for the bacteria). I am not aware of any other name, it is a test looking for formation of bands of antibodies. As I said I too do not think MS likely with normal MRI though, so no big XXXXXXX if it wasn't done.

As for the other info you add to your history, it doesn't change my initial opinion that much (but makes MS even less likely), of a benign inflammation of cord and nerve roots. Guillain Barre is inflammation of the nerve roots as well, but it is usually due to an autoimmune response which while often preceded by an infection takes some weeks to develop, not only one day before.

I hope to have been of help.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Olsi Taka 14 minutes later
Great. Thank you for your help. 1 more thing.

I was told that the fact that WBC are the only thing raised shows the underlying cause is on the decline. Proteins would show an active infection. Are WBC typically the last level to return to normal?
doctor
Answered by Dr. Olsi Taka 6 hours later
Brief Answer:
Yes

Detailed Answer:
Sorry for the late answer.....bed time in Europe.

Yes, I agree with what you were told, the white blood cells would be the last to return to normal in the case of an infection.

Wishing you good health.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Olsi Taka

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