JmJm and others

[copyman]

Hi, had a question about my blood work. i will post my results then ask the question.
WBC 4.7       Limits 4.0-10.5
RBC 4.67             4.10-5.60
hemo 13.6            12.5-17.0
hemocrit 40.5        36.0-50.0
MCV      87          80-98
MCH      29.1        27-34
MCHC     33.6        32-36
RDW      13.4        11.7-15
plates   198         140-415
neuts    55          40-74
lymphs   35          14-46
mono's   8           4-13
Eos      2           0-7
Basos    0           0-3
neuts (abs) 2.6      1.8-7.8
Lymphs(abs) 1.6      0.7-4.5
mono's(abs) 0.4      0.1-1.0
Eos (abs)   0.1      0.0-0.4
Baso(abs)   0.0      0.0-0.2
AST         33       0-40
ALT         50       0-55

All other within normal range except cholestrol.
My question is my WBC has went from 6.8 to 4.7 in a little over a year. seems like it goes down slightly every blood test i had in the last year. i am in a wait and see mode with the new drugs and have not treated yet. should i be concerned with the WBC dropping even though it is still in the normal range? does HCV cause the WBC to drop even without treatment? thanks in advance

[Cindy10]

Yes I believe it does. My husband WBC slowly dropped over time and he was always on the low end of normal. This past year prior to tx it was even lower.
I think that is normal.

[jmjm530]

Probably a good question for a hepatologist, but in general there are lots of reasons why WBC goes up and down and since you've been in the normal range, I suppose one might ask if the decrease was indeed something positive instead of viewing it as something negative. Really don't know.
(http://www.labtestsonline.org/understanding/analytes/wbc/test.html#what)

Be well,

-- Jim

[ladybug52]

Well, there you have it from 2 in the know. As Jim said  maybe look at it as a positive thing. (something those of us with hep c are not use to doing)
Those numbers all look good to me. Looks like you're smart to not have been on tx the last 4 months! (assuming you would have started in Jan)
Bug

[NYgirl]

Hey, am I an "Other"?

Oh dear and here I thought I was one of the members of Oceanic Flight 815!

;)  Just for all the Losties to understand I guess.  :)

[ladybug52]

Certainly not an other, you're an entity within yourself! A legend in your own time. A big fish in a small pond. A rebel with a cause. A leader among leaders A.....(ran out of cliches'):)

[GoofyDad]

Hey copyman, you copied your whole CBC - you truely ara a copyman!

Have your platelets been trending down too? That might give me pause if I saw WBC and platelets heading down to the holler hand-in-hand...  

[nitramog]

how do you feel day to day ?

[copyman]

thanks for the responses,

Goofy, the platelets were 204 when the WBC was 6.8 a little over a year ago.  recent test was 198 so they have not dropped that much. are you thinking the spleen? the last ultrasound 8/05 my spleen was 12.1 cm. and during recent exams the hep docs have said spleen and liver were not enlarged.

nitra, i do not feel that bad day to day except the usual HCV stuff, some fatigue, etc

not sure if this would have anything to do with the WBC getting lower but i have a high VL of btwn 4-12 million?
since i posted earlier today i did some poking around the www and came up with a few things, low WBC can be caused be viral infections, stupid question but is HCV a viral infection?
and WBC can be higher later in the day, most of my blood tests were first thing in the morning due to fasting for glucose & lipids. so maybe i will try getting test done in the afternoon and see what happens.

[jmjm530]

Goofy, I agree with platelets, but have you come across something that suggests a declining WBC is related to progressive liver damage? Not sure I see the connection.

Copy, I don't see a meaningful difference between "204" and "198". I often got more of a variance (up and down) from my monthly CBC's. Really wouldn't read more into your WBC than warranted.

-- Jim

[GoofyDad]

Low WBC can be a sign of cirrhosis. I my case the WBCs and platelets generally parallel one another - I imaging that's 'normal' for cirrhotics, but not so sure about that.    

[copyman]

thanks jim, i forgot to say thanks to you in my previous response. as always i really appreciate your input. happy easter

PS, is HCV a "viral infection" ? as i posted in my last post i have read that you could get a low wbc from a "viral infection". thanks again

[GoofyDad]

Here's a snip from medhelp in 2000.  I should stress that this does not seem to be what's sent copy's cells on holiday....

Patients with hepatitis C and cirrhosis can have a decreasing white cell count for a couple of reasons. First as the liver becomes more “fibrosed” or cirrhotic (this is an advanced form of fibrosis), it becomes difficult for blood to flow through the liver and the blood can back up in the spleen and cause the spleen to become enlarged. The enlarged spleen starts to chew up both platelets and white cells and patients with cirrhosis can develop low platelet and white cell counts. We call this hypersplenism. In addition, some scientists have found evidence that white cells from patients with cirrhosis just don’t live as long in general as do white cells from patients without liver disease.

[jmjm530]

I guess it is in a sense but low WBC can also be caused by some of the more benign viruses like a bad cold, I presume. If you checked out the link I posted above, you'll see the list quite extensive for potential causes of WBC. My WBC is also in the low normal range and my doc doesn't seemed concerned. Have you thought about trotting up to Dr. A. in Boston to get a Fibroscan? Not sure if necessary but it  might answer a lot of questions.

-- Jim

[Cindy10]

My doc says although the  low WBC can be from increased damaged (hubby does have cirrhosis, but also due to the ongoing fight against the infection (HCV). When hubbys WBC was at its lowest prior to tx his VL was <615.