Why might I have and high wbc

[ramm0618]

I had two surgeries in 2016 and have yet to be the same. Emergency gall bladder and complete hysterectomy at two different times. Ever since gall bladder surgery, i have been so swollen in my arms, hands, face, fingers, stomach.. i am most swollen when I wake, but stay swollen through out the day even with taking a diuretic. My vitamin D stays low even though I’ve been taking 51,000 iu 2X a week for almost a year. It’s only 38. Without the huge doses, it goes way low.. so obviously my body is not retaining it. I have not been able to lose weight and I’m one of the most discipline dieters.. i eat healthy anyway, but I don’t cheat when I’m dieting. My cholesterol is high too. The good cholesterol is low(which should be high) and the bad cholesterol is high... my blood pressure is great. My wbc is 13.2 and my red blood cells are high normal.. i had high absolute lymphocytes and high immature granulocytes. Please help me figure this out....

[Ken_PA]

Not TMI at all, it takes lots of info to understand a case like this.

And bingo, here is what I was looking for, re the granulocyte breakdown:
"ABSOLUTE BASOPHIL COUNT 0.1 0.0-0.1 K/uL"

That's at the very upper edge of normal, almost in the high zone. Basophils are similar to the very important MAST CELLS, which cause swelling. This is very likely at the center of your problems.

The term "granulocyte" means that they are cells (cytes) that contain granules, and the granules contain powerful biochemicals. One such chemical is the famous HISTAMINE, which causes fluid to leak from the blood vessels out into the tissues. That's your swelling from water (not from calories of course). That's also runny nose from allergies. Mast cells also put out many other powerful biochemicals that have a large variety of effects.


Do you get very bad reactions from bee stings?

"my skin literally gets tight from swelling"
Likely your mast cells again. And that is a valuable clue because it's rare.

Do you feel dehydrated a lot? Drink a lot of water? Have you had a creatinine/BUN blood test?

[ramm0618]

Report Result Ref. Range Units Status Lab
SODIUM 141 134-145 mEq/L Final
POTASSIUM 4.1 3.4-5.4 mEq/L Final
CHLORIDE 101 97-109 mEq/L Final
CO2 27 22-32 mEq/L Final
GLUCOSE 84 65-99 mg/dL Final
BUN 10 5-26 mg/dL Final
CREATININE 0.9 0.5-1.5 mg/dL Final
CALCIUM 10.1 8.5-10.3 mg/dL Final
PROTEIN 7.7 6.1-8.3 g/dL Final
ALBUMIN 4.3 3.7-5.2 g/dL Final
ALKALINE PHOSPHATASE 87 38-126 IU/L Final
ALT (SGPT) 22 7-52 IU/L Final
AST (SGOT) 29 13-39 IU/L Final
BILIRUBIN, TOTAL 0.4 0.2-1.5 mg/dL Final
A/G RATIO 1.3 1.1-2.5 mg/dL Final

[ramm0618]

I haven’t been stung by a bee in years and years... but I had terrible reactions as far as skin swelling and red and hot.. my throat didn’t swell or anything.

I am probably dehydrated. I drink when I feel thirsty, but I should probably drink more but when I do I feel super bloated. I take a diuretic, but I don’t go to bathroom often. Is that weird?

What can I do about all of this???

[Ken_PA]

I think we can make some progress on Dx'ing this :)

Do you have any CBC that breaks down your granulocytes as to which one is high? Eosinophils, basophils, and also what are your neutrophils?

I think that you are correct that the gallbladder surgery triggered this, possibly a runaway immune reaction. That can certainly cause chronic tiredness, too.

Would you say that your sleep in unrefreshing?

Do you have blood relatives with odd immune conditions? Lupus, bad allergies, Raynaud's?

Do you get spontaneous flushing of the skin?

Do you get lightheaded when standing?

Did you have any bad reaction to the surgery anesthesia?


(It's very good that your answers are so thorough.)

[ramm0618]

CBC WITH DIFF PLUS ABSOLUTE COUNTS 05/27/2018 (#1966748, Final, 05/23/2018 2:39pm)
Report Result Ref. Range Units Status Lab
WBC 13.2 3.8-11.5 K/uL High Final
RED BLOOD CELL COUNT (RBC) 5.24 3.60-5.30 M/mm3 Final
HEMOGLOBIN (HGB) 15.0 12.0-16.0 gm/dL Final
HEMATOCRIT (HCT) 45.6 37.4-48.3 % Final
MCV 87.0 81.0-102.0 fL Final
MCH 28.6 26.9-35.0 pg Final
MCHC 32.9 30.4-34.8 g/dL Final
RDW 43.4 38.6-53.8 fL Final
PLATELET COUNT 379 137-397 K/cumm Final
NEUTROPHILS AUTOMATED 59.4 41.0-77.0 % Final
LYMPHOCYTES AUTOMATED 32.8 14.0-48.0 % Final
MONOCYTES AUTOMATED 5.6 4.0-13.0 % Final
EOSINOPHILS AUTOMATED 1.3 1.0-8.0 % Final
BASOPHILS AUTOMATED 0.5 0.0-1.5 % Final
IMMATURE GRANULOCYTE AUTOMATED 0.4 0.0-1.0 % Final
ABSOLUTE NEUTROPHIL COUNT 7.9 2.0-8.2 K/uL Final
ABSOLUTE LYMPHOCYTE COUNT 4.3 0.9-3.6 K/uL High Final
ABSOLUTE MONOCYTE COUNT 0.7 0.3-1.0 K/uL Final
ABSOLUTE EOSINOPHIL COUNT 0.2 0.0-0.6 K/uL Final
ABSOLUTE BASOPHIL COUNT 0.1 0.0-0.1 K/uL Final
ABSOLUTE IMMATURE GRANULOCYTE 0.05 0.00-0.03 K/uL High Final
RESULT NOTE Test perform

[ramm0618]

My sleep is not usually refreshing. I toss and turn.  I don’t have blood relatives with lupus or anything you mentioned, but my mom has autoimmune hepatitis along with arthritis.

My grandmother died from adrenal gland cancer which is very rare..
i only have flushing if I’m having a hot flash. I do have lots of allergies to grass and trees and pollens, etc. when I go outside and especially in the heat, my skin literally gets tight from swelling.

I’ve never had bad reaction from anesthesia. I do throw up hours later. I don’t really get light headed when standing but I do sometimes when I use the bathroom... I hope this isn’t TMI!!  I can’t thank you enough for your help. I’m so desperate.

[Ken_PA]

Lymph nodes normally get enlarged to fight some infection. When they don't go down afterwards as they should, it would usually be from internal buildup of scar tissue (fibrosis). Or it could be from a chronic infection, like EB virus. Or 'granulomas' inside. That could very well be related to elevated WBCs.

I'd have to think about how the low vit D fits in, it could be a cause or an effect. The same for elevated RBCs.


Can you get the sonogram reports? If they say
"fatty hilum" or "normal architecture" is present, you can stop worrying about lymphoma. (I wouldn't worry about lymphoma anyway at this  point.

I'll be back later...

[ramm0618]

Yes, I’ll look for report! Thank you so much for helping me. I’m not sure if I mentioned how tired I’ve been since having gall bladder surgery in ‘16. I teach part time and get off by 2:00. When I get home, I’m resting . On weekends, it’s hard to do anything for my lack of energy as well. So the swelling and lack of energy are causing me not to be able to enjoy life with family and friends..

[Ken_PA]

Okay, I just took a *quick* look and Effexor doesn't seem to cause any of your symptoms. It's best to check more than one source, though.

I believe that testosterone can make your cholesterol go bad.

Leukocytosis (high WBC) can be caused by stress and/or stimulants (Adderall). But your WBC is not near high enough to think of leukemia, btw.


It's a good idea to first identify which symptoms can be caused my meds, then focus on what remains. Have you been able to sort through all that procedure yet?

Have you had your cortisol level tested?

[ramm0618]

My cortisol levels were normal last time they were checked, but it may have been 6 months ago. I have tried to research my meds and see if that could be cause.. is it weird that my wbc is high and my red blood count is “almost” high?
Wonder why I can’t retain Vitamin D?
Do you think lymphoma is something not to worry about either? I have had an enlarged lymph node in my left arm pit for years. My dr has had 2 ultrasounds on it. All they tell me is lymph nodes enlarged... can they be enlarged for no good reason?

[Ken_PA]

Hi, first off: was your gall bladder empty of stones ("acalculous") ?  If so, that would point to an immune system gone awry.

2nd: are you taking any medications, e.g. steroids?

[ramm0618]

I did have a few stones in my gall bladder.

I’m taking hormones: progesterone, estrogen, was taking testosterone but now my testosterone is too high...
I’m taking adderall, vit D, diuretic, acid reducer, Effexor