Elevated White Blood Cell Count: Causes and Next Steps - Internal Medicine

More Info

---

Understanding elevated white blood cell (WBC) counts can be quite complex, especially when there are underlying health conditions and symptoms involved. In your case, you have a history of myasthenia gravis and have been experiencing persistent mild fever and fatigue for several months, along with elevated WBC counts noted in multiple tests.
Firstly, it's important to recognize that elevated WBC counts, also known as leukocytosis, can occur for a variety of reasons. Common causes include infections, inflammation, stress, allergies, and even certain medications. Given your recent history of recurrent respiratory infections, it is plausible that your elevated WBC count is a response to ongoing inflammation or infection in your body.
In your situation, the fact that you have been experiencing symptoms such as fever, fatigue, and localized pain (in your throat, ear, and back of the head) suggests that there may be an underlying infectious or inflammatory process that has not yet been fully identified. The normal findings from your X-ray and inflammatory markers are reassuring, but they do not completely rule out the possibility of a chronic infection or another condition that could be causing your symptoms and elevated WBC count.

Since you mentioned that your elevated WBC counts have been noted in both general practice and gynecological evaluations, it may be beneficial to consult with a hematologist. A hematologist specializes in blood disorders and can provide a more comprehensive evaluation of your blood counts, including looking for any abnormal cells or signs of hematological conditions such as leukemia, especially given your family history of leukemia.
Additionally, it would be wise to consider other specialists based on your symptoms. For example, an ear, nose, and throat (ENT) specialist could evaluate your throat and ear pain further, as these could be indicative of an ongoing infection or another issue that may not have been fully addressed.
In terms of next steps, I would recommend the following:
1. Follow-Up Testing: If your WBC count remains elevated, further testing may be warranted. This could include a complete blood count (CBC) with differential to assess the types of white blood cells that are elevated, as well as additional tests to rule out specific infections or conditions.

2. Specialist Referrals: Given your symptoms and elevated WBC counts, consider referrals to a hematologist and an ENT specialist. They can provide targeted evaluations and management based on their expertise.

3. Monitoring Symptoms: Keep a detailed log of your symptoms, including any changes in fever, fatigue, or pain. This information can be invaluable for your healthcare providers in determining the next steps in your care.

4. Consideration of Underlying Conditions: Given your history of myasthenia gravis, it is important to consider how this condition and its treatment may interact with your current symptoms and elevated WBC counts. Discussing this with your neurologist may also provide insights.

In conclusion, while elevated WBC counts can be concerning, they are not definitive for a specific diagnosis like leukemia without further investigation. Your symptoms and the context of your health history are critical in guiding the next steps in your care. Engaging with the appropriate specialists and continuing to monitor your symptoms will be key in uncovering the underlying cause of your elevated WBC counts and associated symptoms.