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Forum Name: Leukemia

Question: High wbc and segs

 rajf1271 - Tue Nov 11, 2008 3:34 pm

About 3 weeks ago I went to my primary doc because I wasn't feeling to hot. Totally rundown, off and on fever kind of like the flu. Doc sent me for bloodwork and here is what came back all three times,

wbc 20.4
ne# 15.3
mono# 1.4
segs 81

she has me going to a hematologist and the appt is three weeks away, just curious how worried I should be or if this could just be an infection, although back in april and august my bloodwork was the same.
 Dr. Safaa Mahmoud - Wed Nov 12, 2008 2:29 pm

User avatar Hello,
Normal values for while blood cell and its elements are:

4,500-10,000 white blood cells/mcl.
Neutrophils: 40% to 60%
Lymphocytes: 20% to 40%
Monocytes: 2% to 8%
Eosinophils: 1% to 4%
Basophils: 0.5% to 1%
Band: 0% to 3%

Elevated Total leukocytic count can occur in different condition like:
- Infections, bacterial, viral or fungal.
-systemic disease like Rh. Arthritis, Psoriasis, inflamtory bowel diseases and vasculitis as well as physical stress.
- Cancer especially hematologic malignancies.

Specific increase in one blood element is more indicative of certain medical conditions, e.g
- esiophilia in allergic people, and parasitic infection,
- monocytosis is commonly seen in bacterial infections,
- neutrophilia (like in your case) in most infections and tissue damage like inflammatory and metabolic diseases.

Other known causes include:
Smoking is well documented to increase the white cell count.
Hereditary neutrophilia is another cause.

Although a higher than 11,000 white cells/mcl of blood is considered high, in leukemias the white blood cell counts can reach 100,000.

Other tests known to be elevated in tissue damage and inflammatory conditions are ESR, LDH and CRP. So, having an idea about their level would be helpful.

When leukemia is suspected Bone marrow Aspirate and biopsy should be evaluated. Other symptoms like loss of weight, generalized weakness, fever, headache and bony pains, are warning although shared by both active inflammatory (tissue damage) and malignant causes.

Persistent elevation in the white blood cell count should be investigated properly to exclude both chronic systemic inflammatory conditions and malignancy.

I would advise you to follow up with your doctor.
Please keep us updated.
Best regards.

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