Does Ankylosing Spondylitis Increase Risk of Low White or Red Blood Cells? - Internal Medicine

More Info

---

Ankylosing Spondylitis (AS) is a type of inflammatory arthritis that primarily affects the spine and the sacroiliac joints in the pelvis. It is characterized by chronic inflammation, which can lead to pain and stiffness in the back and hips. While AS itself does not directly cause low white blood cell (WBC) or red blood cell (RBC) counts, there are several indirect mechanisms through which it may influence blood cell levels.

Firstly, chronic inflammation associated with AS can lead to a condition known as anemia of chronic disease (ACD). In ACD, the body’s response to prolonged inflammation can result in the sequestration of iron and a decrease in erythropoiesis (the production of red blood cells). This means that while the bone marrow is functioning, the inflammatory cytokines can inhibit the production of RBCs, leading to a mild anemia. Therefore, patients with AS may experience lower RBC counts due to this mechanism, particularly if their disease is not well-controlled.

Secondly, while AS itself does not typically cause leukopenia (low white blood cell count), the treatments used for AS, such as non-steroidal anti-inflammatory drugs (NSAIDs) or disease-modifying antirheumatic drugs (DMARDs), can have side effects that affect blood cell counts. For instance, some DMARDs can suppress bone marrow function, leading to lower WBC counts. It is crucial to monitor blood counts regularly in patients receiving these treatments to catch any potential side effects early.

Moreover, if a patient with AS experiences flare-ups or complications such as infections, this can also lead to fluctuations in WBC counts. Infections can cause an increase in WBCs as the body responds to fight off pathogens, but in some cases, particularly if there is a severe infection or sepsis, the WBC count may drop due to the overwhelming nature of the infection.

In summary, while Ankylosing Spondylitis itself does not inherently increase the risk of low white or red blood cell counts, the chronic inflammation associated with the disease and the treatments used can lead to changes in blood cell levels. It is essential for patients with AS to have regular blood tests to monitor their blood counts, especially if they are on medications that could affect bone marrow function. If there are concerns about low blood cell counts, it is advisable to discuss these with a healthcare provider who can evaluate the situation and determine if further investigation or treatment is necessary. Regular monitoring and a comprehensive approach to managing both the disease and its treatment can help mitigate potential complications related to blood cell counts.