Persistent High White Blood Cell Count: Causes and Next Steps

Elevated white blood cell count?

My company's health check has been ongoing for nearly eight years, and there has consistently been an issue with elevated white blood cell counts, typically ranging from 11 to 14.
Other types of white blood cells have shown no problems.
In the fifth year, I underwent an examination at a major hospital, where they stated that all other values were normal and that there was likely a mild inflammation in my body, which gave me some reassurance.
However, during this year's company health check, my white blood cell count was found to be 14.4, and my platelet count was also elevated.
Recently, I have been experiencing increased sensitivity, redness, poor appetite upon waking, and some back pain in the morning.
Is there a problem? Given that my white blood cell count has been consistently high each year, is treatment necessary? Which department should I consult to further investigate what issues my body may have? Thank you for your hard work!

Che, 30~39 year old female. Ask Date: 2021/11/13

Dr. Chen Bozhang reply Family Medicine

Dear Ms.
Che,
You mentioned that you have had elevated white blood cell counts for several consecutive years, which may be due to normal physiological variation or a potential underlying inflammatory disease.
This year, both your white blood cell and platelet counts are elevated, and you are experiencing symptoms such as easy allergic reactions, poor appetite upon waking, and some back pain in the morning.
These may be related to reactive changes caused by certain diseases.
I recommend that you consult a rheumatology and immunology specialist (a subspecialty of internal medicine) to discuss possible conditions in detail and undergo appropriate examinations, which will provide an opportunity for targeted management.
Sincerely,
Dr.
Chen Po-Chang, Department of Family Medicine, Keelung Hospital, Ministry of Health and Welfare

Reply Date: 2021/11/13

More Info

Persistent high white blood cell (WBC) counts can be concerning, especially when they consistently fall outside the normal range. In your case, a WBC count ranging from 11,000 to 14,000 cells per microliter (µL) over the past eight years, with a recent spike to 14.4, indicates a chronic condition that warrants further investigation.

Understanding High White Blood Cell Counts
White blood cells are crucial components of the immune system, helping the body fight infections and other diseases. A normal WBC count typically ranges from 4,500 to 11,000 cells/µL. Counts above this range can indicate various conditions, including:
1. Infection: The body may produce more white blood cells in response to infections.

2. Inflammation: Chronic inflammation from conditions like arthritis or inflammatory bowel disease can lead to elevated WBC counts.

3. Stress Response: Physical or emotional stress can temporarily increase WBC counts.

4. Allergic Reactions: Allergies can also cause an increase in certain types of white blood cells, particularly eosinophils.

5. Bone Marrow Disorders: Conditions such as leukemia or myeloproliferative disorders can lead to persistently high WBC counts.

6. Other Medical Conditions: Conditions like chronic obstructive pulmonary disease (COPD), diabetes, or even certain medications can affect WBC levels.

Symptoms and Their Implications
You mentioned experiencing symptoms such as increased sensitivity to allergies, skin redness, decreased appetite, and back pain upon waking. These symptoms could be related to various underlying issues, including:
- Allergic Reactions: If you are experiencing increased allergic responses, it may correlate with your elevated WBC count, particularly if eosinophils are elevated.

- Chronic Inflammation: Back pain and decreased appetite could suggest an inflammatory process, which might be contributing to your elevated WBC levels.

- Stress or Fatigue: Chronic stress can lead to a range of physical symptoms, including pain and changes in appetite.

Next Steps
Given your history of elevated WBC counts and the recent increase, it is advisable to take the following steps:
1. Consult a Hematologist: A specialist in blood disorders can provide a comprehensive evaluation of your blood work. They may recommend further tests, such as a complete blood count (CBC) with differential, bone marrow biopsy, or specific tests for infections or inflammatory markers.

2. Monitor Symptoms: Keep a detailed record of your symptoms, including their frequency and severity. This information can help your healthcare provider make a more accurate diagnosis.

3. Consider Lifestyle Factors: Evaluate your lifestyle for potential contributors to your symptoms and elevated WBC count. Factors such as diet, exercise, stress levels, and sleep quality can significantly impact your overall health.

4. Follow-Up Testing: Regular monitoring of your blood counts can help track any changes over time. If your WBC count continues to rise or if you develop new symptoms, further investigation will be necessary.

5. Allergy Testing: If you suspect allergies are contributing to your symptoms, consider consulting an allergist for testing and management options.

Conclusion
While a persistently high WBC count can be concerning, it is essential to approach the situation with a comprehensive evaluation. By consulting with a hematologist and monitoring your symptoms, you can gain a clearer understanding of your health status and determine the appropriate next steps. Early intervention and management can help address any underlying issues and improve your overall well-being.

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