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Family Medicine  (Expert Forum)
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Lower Total WBC and Elevated SED Rate
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD Boston - MA
Questions in the Family Medicine forum are answered by Dr. J.M. Keyes. Topics covered include general health issues, adolescence, babies, child health, eating disorders, fitness, immunizations and vaccines, infectious diseases, medical tests and procedures, and senior health.

Lower Total WBC and Elevated SED Rate

by albot, Apr 14, 2006 12:00AM
I recently had a full blood panel, plus PSA, lipids and generally everything looked ok except a slightly lowered WBC and and elevated SED rate. In the CBC my differentials were all in the normal range but on the lower end of normal which would show why the total WBC was 4.6, where the hosiptal lab normal range was 5-10. I have seen some labs where normal is 4.5 to 10 or 4.0 to 11. I have had my WBC lower than this before but was in the normal range at another lab.



1. Is this lower WBC count considered a minor decrease, especially when in another lab it would be normal? Is it true that lymphomas can cause a lower total WBC?



As far as SED Rate, the lab normal range is 10-20, and mine was 30.



2. Is this considered a high value or minor elevation? It seems that in the last 2 years some blood tests have been normal SED rate and then others have been slightly elevated. Can someone have an elevated SED rate that is idiopathic?

by Kevin Pho, MD, Apr 14, 2006 12:00AM
To answer your questions:

1) I would repeat the CBC to ensure it isn't lab error.  A low WBC can be indicative of serious disease like leukemia or infection.  If it persists to be low, a hematology evaluation can be considered to further evaluate this.  



2) An ESR of 30 is a mild elevation.  This is a non-specific marker if inflammation - and a variety of diseases can elevate this, including infection, acute injury, any source of inflammation or rheumatological disease.



These questions can be discussed with your personal physician.



Followup with your personal physician is essential.



This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.



Kevin, M.D.

kevinmd_b
Member Comments (1)

by albot, Apr 14, 2006 12:00AM
To: Dr. Pho
I was hoping to have my question answered as to whether this seems like a minor elevation(the wbc count) and would it be normal in other labs since it is in the normal reference range for other labs?



Thanks
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