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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes low neutrophil count?

Answered by
Dr.
Dr. Iven Romic Rommstein

General Surgeon

Practicing since :2008

Answered : 13155 Questions

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Posted on Tue, 7 Jun 2016 in Blood Disorders
Question: WHAT DOES IS MEAN TO HAVE THE NEUTROPHIL COUNT LOW - 28.2 (RANGE IS 42 - 75) COMPARED TO THE LYMPHS WHICC SEEM TO BE HIGH - 51.6 (RANGE 20-50) WITH MONO AT 11.3% (RANGE 2-10) ON MY MOST RECENT BLOOD WORK. I HAVE RHEMATOID ARTHRITIS AND TAKE HUMIRA AND METHOTROXATE WEEKLY.
doctor
Answered by Dr. Iven Romic Rommstein 47 minutes later
Brief Answer:
Side effect of medications

Detailed Answer:
Hi and welcome.
Lower neutrophils are consequence of metotrexate which is strong cytotoxic medication and has effectively on production of white blood cells. Lymphocytes are not significantly increased. This neutrophil count is tolerable and it won't lead to increased infection rate,however,if it falls progressively,you should reconsider methotrexate dosage with your rheumatologist. Wish you good health. Regards
Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Iven Romic Rommstein 5 hours later
What word did you want to put after the word "effectively" in your answer? Also, Is there a substitute drug you'd recommend instead of methotrexate which does the job of knocking down the RA symptoms of pain and inflammation, that won't lower the neutrohil count and/or raise the lymphs? Seems my Dr. is very concerned about the numbers with low neutrophil count compared to the lymph count. Please write back as that is the real answer that I am seeking. Thanks so much, XXXXXXX
doctor
Answered by Dr. Iven Romic Rommstein 7 hours later
Brief Answer:
Hi

Detailed Answer:
mistake. I meant to say that it has negative effects on wbc production. Methotrexate dosage should definitely be reduced. It can be replaced with sulfasalazine or leflunomide,but if methotrexate works good for you then I wouldn't stop it completely,but better reduce it to previous dosage first and then check your neutrophils in 2 weeks.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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