WBC count question

[zoobymoo]

I had some routine bloodwork done in June and I had a low WBC count of 3.1 (normal range 3.8-10.8) Neutrophils 1290 (1500-7800) were the only ones low. All other WBC were in range. I also had signs of iron deficiency anemia. MCV was low and RDW high.

I went back last week for a follow up after having started taking multivitamins and some iron supplements in the summer. Everything in the red blood count is normal now. WBC is in normal range of 4.2. However the neutrophils is still low 1483 (again normal being 1500-7800) Everything else is as follows:
lymphocytes 2045 (normal 850-3900)
Monocytes 496 (200-950)
Eosinophils 155 (15-500)
Basophils 21 (0-200)

The % breakdown is
neutro 35.3%
lympho 48.7
mono 11.8
eosin 3.7
baso .5

Platlet count is normal at 222 thousand

My doctor wasn't concerned as the WBC count had gone up and is now in range. Does this seem normal?

Feedback appreciated. Thanks

[riley180]

Hi.
UTI's rarely become severe enough as to cause neutropenia. But judging from what you've written, the UTI doesn't sound debilitating.  Neither is Ciprofloxacin a suspect, its actually a drug given for people with neutropenia already, although there are some occasional reports that Cipro may produce neutropenia.
In all likelihood, its probably insignificant. Bear in mind that all tests are based on averages, and the definition of normal by convention places 5% of the population as abnormal, even though they are healthy. I'd be more worried when results are completely normal and there are obvious symptoms, rather than borderline results when there are no symptoms at all. There are some tests that can be used to screen for specific diseases - CBC however isn't really specific for anything.

[zoobymoo]

thanks for your reply. BTW I am a 20 year old female. I had bloodword done at 16 and everything was fine including the WBC count. I had a UTI for a prolonged period about 6+ months before I actually got a chance to get to the doctor as I was haing issues with insurance. But anyway I was put on Cipro and its gone now. I finished the cipro 2 weeks before the latest blood test. Do you think that might affect the WBC count at all b/c I read somewhere prolonged bacterial infections can cause neutropenia.

[riley180]

Hi.
In the absence of any other problems/symptoms, the values are not significant.
There are two methods of doing the CBC, an automated and a manual reading.

The automated reading suffers from machine classification errors. The machine may sometimes classify a lymphoctye as neutrophil, and so on. Hence, when the count is normal, the accuracy of the neutrophil and lymphocyte proportion is harder to ascertain, as each erroneous count impacts on the proportion of neutros and so on.

The manual method suffers from variable preparation of the slide. Occasionally, the blood smear may be too thin or too thick, and hence the proportions of WBC subtype populations may also be erroneous.

The accuracy of either method improves when there is an abnormality of the total count, whether it is too low or too high.

It is entirely possible that the actual counts were merely underestimated during the first determination. Another scenario is that you may have had an infection, probably viral, that your body handled pretty well and thus you had no symptoms. Whichever scenario is operative, there seems no cause for alarm.