low wbc

I'm a 35 year old male. I went to my Fam. Dr. after I started getting minor muscle twitches in both my calves, both feet, legs and sometimes my nose and a few in my arm. They last for a few seconds then go away then come back again. It's been going on for about a week, mostly at rest. I've been under a great deal of stress since December when my father went to the hospital and was dx'd with cancer they couldn't treat. Lost about 15 pounds I didn't need to lose from the stress and flu I got at Christmas. He is still there having other complications. Haven't been sleeping good and I'm very tense. I've always had a type A personality. Anyway my Dr. ordered a CBC. Everthing fell into the normal range except my WBC which it said was 3.9. Normal range 4.8-10.8. This is the rest of my results which it said were normal:
RBC-5.13, HGB-15.8, HCT-46.1, MCV-89.9, MCH-30.9, MCHC-34.4, RDW-12.6, PLT-204, MPV-8.1, LYMPH%-40.4, MONO%-7.1, GRAN%-50.5, EOS-1.6, BASO-0.4, LYMPHOCYTE#-1.6, MONOCYTE#-0.3, GRAN#-2.0, E0#-0.1, AST/SGOT-30, ALT/SGPT-27. Potassium and Sodium were normal. The only other Abnormal readings were my CO2-32 normal range 22-29 and Albumin-4.9 normal range 3.4-4.8. Also SED RATE was 2, BASO#-0.0. ANA Screen-negative and RHEUM Factor 5.2.
The nurse called me and said blood work was normal. I asked to have them faxed to me and saw the abnormal findings. My question is should I be concerned about the low WBC? What causes low WBC? Should I be concerned about the other high numbers? Why did my Dr. say they were normal? One last question is why do you think I'm getting the twitches? I'm kind of a Hypo. anyway and when I see abnormal findings I get freaked out. Thanks in advance.

[Kevin Pho, MD]

There are several causes for a low WBC.  This can include various types of infection (including HIV), medications, vitamin b12 deficiency, bone marrow diseases, as well as medications to name a few.  The differential (i.e. percentages of monocytes, granulocytes etc.) do not indicate a marked cause.

Certainly more evaluation should be considered.  The first would be repeating the test, to see if the WBC persists to be low.  If it does, then a referral to a hematologist can be considered.

It is difficult to say what is causing the twitching without examining you.  The electrolytes and the blood tests you listed here do not give an obvious cause.  You can consider a referral to a neurologist for further evaluation.

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.
Medical Weblog:
kevinmd_b