Elevated white blood cell count, bone pain (lower back, knees), and a heart rate of 120 beats per minute?
Hello Dr.
Lin,
I am a 30-year-old female, currently maintaining a normal daily routine, going to bed before 11 PM and waking up at 8 AM.
I am a homemaker and have activities scheduled every day.
I have transitioned from the Department of New Medicine to the Department of Nephrology, and I have undergone routine blood tests, including liver, kidney, and urine tests.
The abnormal data is as follows: WBC increased from 10,911 (March 31) to over 12,000 (early April) to 14,200 (April 20), with lymphocyte percentage at 19.7%.
Further tests for C3, C4, ANA, and CRP all returned normal results.
However, I have experienced a consistently elevated heart rate exceeding 100 beats per minute.
Several years ago, an electrocardiogram showed only a left axis deviation without significant issues.
In the past year, I have had multiple episodes of hyperventilation, characterized by shortness of breath, wheezing, followed by dizziness and fainting.
Additionally, I have long-standing cold extremities, with my toenails appearing purple.
I do not have congenital heart disease, but recently I have also experienced bone pain and fatigue.
Could you please advise on how to proceed from here? Thank you very much for your response!
cindy, 30~39 year old female. Ask Date: 2010/05/09
Dr. Lin Jixiong reply Cardiology
Hello: Based on your white blood cell data, there has been a consistent increase from March 31 to April 20, indicating that your body may be experiencing an infection.
Additionally, the clinical symptoms of bone pain and fatigue are also similar to those associated with an infection.
Therefore, it is recommended that you consult a physician for medication to address your discomfort.
Regarding the frequent episodes of hyperventilation, in addition to seeing a cardiologist, it is advised to avoid caffeine-containing foods and beverages (such as tea or coffee), refrain from staying up late, and find ways to relieve stress and stabilize your emotions.
Sincerely, Dr.
Lin Chi-Hsiung, Taoyuan General Hospital.
Reply Date: 2010/05/09
More Info
Elevated white blood cell (WBC) count and increased heart rate can be concerning symptoms that warrant further investigation. Based on the information provided, it appears that you have experienced a significant rise in your WBC count over a short period, alongside persistent tachycardia (heart rate exceeding 100 beats per minute) and other symptoms such as difficulty breathing, fatigue, and cold extremities.
Firstly, an elevated WBC count, known as leukocytosis, often indicates that the body is responding to some form of stress, infection, or inflammation. In your case, the increase from 10,911 to 14,200 suggests that your body may be fighting off an infection or dealing with some inflammatory process. The normal results for C3, C4, ANA, and CRP tests are reassuring, as they indicate that there is no significant autoimmune disease or systemic inflammation present at this time.
Your history of tachycardia could be multifactorial. It may be related to anxiety, stress, or even the physiological response to an underlying infection or inflammation. The symptoms of difficulty breathing and feeling faint could also be linked to anxiety or panic attacks, especially if they occur during periods of stress. However, they could also indicate a more serious condition, such as a respiratory issue or cardiovascular problem, particularly given your description of cold extremities and purple toenails, which may suggest poor circulation.
The combination of symptoms you are experiencing—elevated WBC count, tachycardia, cold extremities, and fatigue—could point to several potential issues. For instance, conditions such as hyperthyroidism, anemia, or even chronic infections could lead to similar symptoms. Additionally, the bone pain and fatigue you mentioned could be indicative of a systemic issue that requires further evaluation.
Given your symptoms and lab results, it is crucial to follow up with a healthcare provider, preferably a specialist in hematology or cardiology. They may recommend additional tests, such as a complete blood count (CBC) with differential, thyroid function tests, and possibly imaging studies to assess for any underlying conditions.
In the meantime, here are some general recommendations:
1. Stay Hydrated: Ensure you are drinking enough fluids, as dehydration can exacerbate symptoms of tachycardia and fatigue.
2. Monitor Symptoms: Keep a diary of your symptoms, noting when they occur, their severity, and any potential triggers. This information can be invaluable for your healthcare provider.
3. Limit Stimulants: Avoid caffeine and other stimulants that can increase heart rate and anxiety levels.
4. Manage Stress: Engage in relaxation techniques such as deep breathing, meditation, or gentle yoga to help manage stress and anxiety.
5. Regular Check-ups: Schedule regular follow-ups with your healthcare provider to monitor your WBC count and heart rate, and to reassess your symptoms.
6. Seek Immediate Care: If you experience severe symptoms such as chest pain, severe shortness of breath, or fainting, seek emergency medical attention immediately.
In conclusion, while elevated WBC counts and increased heart rates can be alarming, they are often manageable with appropriate medical care and lifestyle adjustments. It is essential to work closely with your healthcare provider to determine the underlying cause of your symptoms and to develop an effective treatment plan.
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