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Crohn's Disease Forum » Treatment » Imuran/Azathioprine/6-MP » White blood cell count


02-22-2015, 02:17 PM   #1
tincup
 
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White blood cell count

I have been on azathioprine for 8 months. I am having a great response so far. I have seen a lot of posts talking about it taking 3 months to work on that was spot on for me. I have near complete mucosal healing as evidenced by a flex sig 5 months after starting. Anyway my blood has always been good but last week my wbc was 4.9. Is that low and should I be concerned?. The lab reference for normal is 3.5 to 10.8. In the past my wbc has always been closer to the high end and 4.9 just seems low. Btw I am currently taking 150 mg and I weigh 172. My wbc over the past 7 months has went from 8 to 4.9 and my rbc and platelets have not changed at all since starting aza. Thanks for any encouraging words you guys may have
02-22-2015, 03:02 PM   #2
FrozenGirl
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Well with that range it seems fine but the dramatic drop from 8 to 5 is slightly concerning. Have you checked with your GI on those numbers?
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02-22-2015, 03:21 PM   #3
DustyKat
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I personally wouldn’t worry about that level tincup.

My son has been on Imuran for 4.5 years and his WBC sits around that level too.

You will notice on the blood report that the white cells are further broken down into neutrophils, eosinophils, basophils, lymphocytes and monocytes. These five types of white cells (leukocytes) are what make up the bulk of the White Blood Count (WBC or WCC). So the WBC is an overall reading. Its numbers will move up and down depending on a number of factors some of which include infection, disease or response to medication.

The role of Imuran is to the suppress the immune system of which the white cells play an integral part. Imuran works by suppressing the production of lymphocytes so this will affect your overall WBC.

However the main thing to look to aside from the total WBC is the individual lymphocyte count, neutrophil count and also the platelet count. Imuran should be stopped if the neutrophil count drops below 1.0x10^9/L, the lymphocyte count drops below 0.5x10^9/L or the platelet count below 50x10^9/L.
The platelets are a part of the Full Blood Count (FBC).

I hope that makes sense!

Dusty. xxx
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02-22-2015, 04:05 PM   #4
tincup
 
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Kat,

Thanks for your input as it was helpful and put my mind at ease. I did understand what you said. My lymphocytes were at .98 and my platelets were 344 . I don't remember the neutrophils except they were good. I'm just not used to a wbc around 5ish. Do you think my lymphocytes are ok. Thanks again and I hope your son is doing well.
02-22-2015, 04:24 PM   #5
Catherine
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My daughter is also on imuran. Her GI is aiming for a white cell of 4.
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Mother of Sarah dx aged 16, Jan 2012
DX - CD 1/12, asthma
Small bowel to small bowel fistula

Meds: ), azathioprine 200mg, Mesalazine 1.2g x 2, seretide 250 x 2 (asthma), ventolin (as needed)

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Has previously taken Multi B, Caltrate, B12 & Iron

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02-22-2015, 06:01 PM   #6
tincup
 
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Catherine

Thanks so much. I hope your daughter does well on aza. I guess this is probably where I need to be.
02-22-2015, 06:04 PM   #7
tincup
 
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Frozen girl

I'm sorry I didn't see your post. My drop really wasn't that sudden. The 8000 was last July after one month on aza. Then last October it was at 6500. Doc increased to 150 mg and now it is at 4900. I just hope the decrease stops. Thanks for your reply.
02-23-2015, 12:00 AM   #8
FrozenGirl
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Oh well that doesn't seem concerning then. My doc doesn't get concerned until I get below 4.
02-23-2015, 04:10 AM   #9
DustyKat
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Kat,

Thanks for your input as it was helpful and put my mind at ease. I did understand what you said. My lymphocytes were at .98 and my platelets were 344 . I don't remember the neutrophils except they were good. I'm just not used to a wbc around 5ish. Do you think my lymphocytes are ok. Thanks again and I hope your son is doing well.
At that level your lymphocytes are fine tincup.

Dusty. xxx
03-10-2015, 11:18 AM   #10
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I started Imuran on March 2nd. Blood work was done on March 9th, got the call this morning that my WBC is very low didn't ask the number and platlets are at 89. Which I always run low on Platelets since i am on humira. So she will re-test next week and if its still low I will probably have to get off of the meds. But as i am reading i see alot of you have low WBC and doctors are not concerned.
I am really nervous about this medication and thinking of just not taking it.

Tammy
03-10-2015, 11:39 AM   #11
tincup
 
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From my understanding the medicine is supposed to lower the wbc level as that is what suppresses the inflammation. It us hard to say whether you should stop or not. I would call back my doc and ask for your count. Saying it is very low is not much help. My wbc was 4.9 and my doc thought level was great in his follow up letter to me. There are many people on imuran whose wbc gets down in the 2 range and their doctors are ok with it. Call and see where it is at. For me personally if mine falls below 3.5 then I am going to lower my dose. I'm sure your doc knows what he is doing and if yours is too low he or she will adjust your meds. Try not to worry.
03-10-2015, 03:10 PM   #12
Cricket
 
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Thanks I will call tomorrow and ask the level. I'm such a worry wart which does not help the crohns.
I am so glad I have yall to ask questions makes me feel better 😘
03-20-2015, 04:09 PM   #13
Cricket
 
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So i did blood work and my platelet count dropped to 89 and white blood count is 3.2.
My doctor has taken me off the Imuran for now and will re-test my levels in a week.
03-20-2015, 10:33 PM   #14
FrozenGirl
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I have had a couple dips to below 4 and after being off for a week it almost always fixed the white count and I went back on. Hope it will be the same for you.
03-20-2015, 11:59 PM   #15
tincup
 
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Hang in there. I without doctors advice reduced my dose by 25 mg and my wbc went back to 7.7. I just wanted to test things and now I am back on normal dose. I am sure being off med will rectify your blood work.
06-30-2015, 05:39 AM   #16
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Hi, uhm. I'm in remission and I've been on Aza for almost 2 years (Will be two years this July), and I'm on 75 mg now (with no other medication), and I've never had my wbc go down or anything like that, It's always high (as in 9 or 10.)
Does that mean it's not working on me????
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*Diagnosed at age 13 with severe Crohn's Disease (July 18th 2013) w/ surgery

*Surgery: IC Resection and anastamosis

*Previous Medication: none for treatment before diagnosis but Prednisolone/Metronidazole
- After surgery: Mesalazine

*Currently on: Azathioprine 75 mg
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~.~.~
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Keep fighting. xx
05-14-2017, 10:42 AM   #17
Ashwani Vaishnavi
 
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My WBC count including lymphocyte count never came down insted increased to 12.0 reference range 4.4-11 dispite taki g Azaron for I year still taking 50mg/ day...i am also confused

Ashwani Vaishnavi
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