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Low WCC and Neutrophils


I am wanting the opinion of others into the likely cause of these blood results. I am puzzled myself.
To give some background -  in 2011 - 2013 the Neutrophil count was 1.1 and WCC 3.8. Patient was told to just keep an eye on things. during 2015-2018 the blood counts returned to normal - Neutrophils were 3.3 and WCC 4.5. Now from 2019-2022 the neutrophils have once again dropped and remained around 1.3 and WCC 3.9 persistently. All other bloods are within normal limits. Patient has a history of high ferritin and iron associated with carrying a singular Hemochromatosis gene.

Any ideas as to what might cause this persistent mild neutropenia?
I am assuming nasty pathogens are unlikely since the bloods did return to normal for a while.
Is it possible for the patient to have a slower growing CA such as CLL? I wouldn't think bloods would return to normal with something like this.

Please share your ideas.

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1081992 tn?1389903637
"Is it possible for the patient to have a slower growing CA such as CLL?"
Hi, if you mean some long term cyclic marrow suppression? That's not likely at all.
"I wouldn't think bloods would return to normal with something like this."
Yep, that's correct thinking - plus only the one cell line being suppressed would not be expected behavior, though it's possible since cancer can do almost anything.

I'd instead go right for the hemachromatosis gene --> iron --> neuts--> oxidative burst association. Occam's Razor would tell us to cast about in that direction.

I'd also be aware of the cyclic neutropenias. None of the known ones fit this, but the concept remains that there are neutropenias that are not understood at all. I.e., immune system mysteries, of which there are very many.

I'd also look at what triggers there might have been preceding each episode.

I'd want to know if slightly low neuts were lifelong, in which case the 'normal' count would actually be high for that  individual.

I'd want to know why the Pt was blood tested in the 1st place.
Helpful - 0

The Intro is a good overview to the topic. The results are not particularly meaningful. Though the recent date shows this is emerging.
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