Can GI issue cause neutropenia and elevated cortisol?

[Suki4]

36 years old. Female.   In June 2009, I had a GI bleed for 8 days. My stool was completely black those days and on the seventh day I was hospitalized for anemia/weakness. An endoscopy and colonoscopy were performed and both were negative. No further GI studies were done, and I was discharged. While in the hospital, my blood values showed very low WBC and low neutrophils. I was referred to a hemotologist who has monitored me since then. All my blood counts since June 2009 have shown the same results, low wbc and low neutrophils (absolute). Otherwise, I have been healthy with no increase in infections.  

In January 2011, I began to wake at night with severe bouts of trembling every few days. In Feb, I began to experience pain in my mouth (palate, tongue, gums) along with right flank pain and nausea. By March, the trembling began to increase dramatically, accompanied by an episodic flushing sensation in my face and arms. Both my blood pressure and heart rate would rise as well when these episodes happened.

I was hospitalized for 8 days. I underwent many tests, but all came back normal (except my blood values for wbc and neutrophils). CT of the abdomen was normal as was an MRI of the brain. No sign of gallstones, and my gallbladder contracts normally. I am not diabetic.  

A 24 hour urine test did show an extremely elevated cortisol level, way above the normal range. I was put on a serotonin uptake medicine and that has alleviated the trembling. However, my mouth pain, right flank pain and nausea have persisted. I am still neutropenic.

I have a new internist who has ordered me an upper GI, small bowel follow-through exam next week. She suspects that my GI bleed in June 2009 may have something to do with all of this. She has also ordered me to see an endocronologist due to my cortisol levels being so elevated.

Prior to June 2009, I was never found to be neutropenic.  I do not have an extensive medical history. I am a healthy, happy, and busy wife/mother. I do not have time for these problems. I am thin, with no history of any mental/psych issues (in case someone is wondering).

Could all these issues be related to GI? I am stumped, as is my internist.

[Ken_PA]

and also possible diverse systemic effects from parasite in liver, something maybe similar to schistosomes

(relating to your right side pain)

[Ken_PA]

Here's a shot in the dark:

- pathogen in food or drink adheres to stomach wall
- powerful IgE response (suggestive of parasite)
- which causes massive mast cell degranulation
- histamine->permeability + heparin->anti-coagulation = lots of bleeding

then eventually

- stomach infection is defeated

but

- pathogen hides out somewhere else in body (not GI), causing
--- neuropathies similar to those postulated by Lyme spirochete??? maybe not
--- immune response when pathogen gets sometimes activated, which
-------- results in cytokines, then maybe catecholamines, etc

eventually cortisol gets released an anti response to the immune inflammation. Cortisol should increase PMNs while reducing their activity, but maybe yours are getting destroyed at an ever faster rate. Are yours shifted left?

Infections can cause neutropenia, even some parasites do.

Or it could all be from a virus, they are mysterious anyway. Note that (natural anti-viral) interferon affects BP, etc.

All might be complicated by you having unusually strong immune and hormonal reactions. E.g., not every allergic person has anaphylaxis.