It's 3am in England and its my usual pred night - no sleep until at least 4am

I got home this afternoon to a message on my ansaphone from my Dr telling me that following a blood test on Wednesday my WBC is higher than it should be and that he thinks its probably the pred, if I think I might have any cold/flu symptoms to contact surgery, if I have any questions he is going on holiday for a week and I can ring and speak to another Dr on Monday !

Well apart from the fact that he has my work and mobile numbers he must have known I would have questions !

I have been on pred for 6 months and I know it is making me worse, my neuro told me this week I can't start tapering off as I started on Azathioprine in early December and he says that will not be taking effect and he thinks I would be worse if I started tapering now, I disagree but that's another story.

When I started on Aza I had a base blood test (7th Dec) and I had 2 more 14 & 21 Dec, then the one this week. All the other tests were fine so my question is why after 6 months and 3 normal tests would pred cause this one to be higher ?

Any ideas - I don't think I will get any sensible answer from my surgery on Monday !

Thanks

Prednisone can definitely raise the WBC.. as far as the timing of it (chronic use etc, I don't know, but I imagine it would still elevated it)... How high was it?? Sometimes it could be a simple cold that raises it, or just a normal variation...

Don't know how high, as I said the only details were on a message, will find out next week.

Haven't had a cold or any infections, but MG has been at its worst the last 2 weeks.

Thanks for replying its lonely at this time of the morning !

Sometimes you can request a copy of tests results & reports, it's handy to have on hand for your own records.

Hi, lynned0. I'm sorry you aren't doing well right now. What surgery are you having on Monday?

When someone is on Pred, they can have an infection and only have signs such as an elevated white blood cell count or an erythrocyte sedimentation rate (ESR). It might be a good idea to look at your throat to see if it looks red. Are any lymph nodes in your neck tender or swollen? Are you more tired than usual? Do you have any kind of cough? Have you taken your temperature to see if it's elevated?

Jo*Mar is right - you should get copies of any tests run. That way, if you see a new doctor, you can keep track of any trends in the test results.

Did your doctor test you for the TPMT enzyme BEFORE they started you on the Aza/Imuran? They are supposed to!

http://labtestsonline.org/understand.../tpmt/tab/test

If you do have an underlying infection, it's not a great idea to have surgery during one. I hope they will check you out beforehand to make sure it's safe for you to have it done.

There are a lot of reasons for an elevated white blood cell count. They should keep an eye on it and retest you.

I hope you'll be okay. Let us know how you're doing!


Annie

Thanks to Annie & Jo*Mar for your replies.

I seem to have caused a bit of confusion with the word ' surgery '. In England, under our National Health Service we register with a Doctor who is near to where we live, sometimes that practice is full and we get allocated a Doctor, with no choice. As we don't pay to see the Doctor the service we get is much more restricted. The place where we go to see the Doctor we call a surgery. I presume in days gone by they did actually carry out the surgery there ! We say we are going to 'ring the surgery for an appointment etc' Hope I have cleared that up.

Yes I did have a TPMT test before I started Aza which was fine, as far as I am aware I haven't had an infection and my temperature is normal.

Perhaps it's just one of those anomalies and my next test will be normal.

That's what I am hoping anyway !

Hi all - I have spoken to a doctor, not my usual one and he tells me that my WBC was borderline high on my first 2 tests, 10.2 and 10.8 but the one last week was 13.8. He thinks its the pred but I will re-test early feb. I tried to get him to explain why the pred would cause it to go higher but all he said was you are on a high dose (70mg),which wasn't much of an explanation !

So can any of you knowlegdeable (that doesn't look right) people explain to me how it works ? I thought pred was used to suppress our overactive immune systems and stop the ACHr receptors being attacked, and I also thought white blood cells were produced by the immune system to attack infections. Aren't they part of the same immune system ? How does it manage to suppress one bit and not the other, or are they separate things altogether.

I would be grateful for someone to explain it to me in simple language !

Lynne

hopefully someone can explain WHY it does that... but I do know that it is notorious for elevating the WBC... also at 13, I don't believe that is too concerningly high, especially while on steriods... Pregnancy raises it quite a bit as well, having a simple cold too! Hopefully someone can give you a more scientific answer!

http://www.ncbi.nlm.nih.gov/pubmed/7304648

I believe this is pretty clear.

They should make sure that you don't have some underlying infection. Pred can mask an infection.

Annie