What can cause low WBC count?

Question

Hi doctor,

My father-in-law is 58 years old. He had a stroke a year back and has been diagnosed with non-critical CAD.

Within a period of two months, his WBC count has reduced from a range of 7.5 to 2.8. But there is no sign of infection. The overall count of ANC is more than 1000, and platelets are 140. We consulted a doctor, and he has advised us to take a few multivitamins and keep a weekly check on the count.

How should we proceed further?

Please guide.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

Based on your query, my findings are as follows.

Your dad is suffering from macrocytic anemia along with leukopenia (low-level WBC) and pancytopenia (deficiency of RBC, WBC, and platelets).
There is only a slight decrease in the number of platelets, so you need not worry.
Megaloblastic anemia can occur secondarily due to vitamin B12 and folic acid deficiency.
It is advisable to take multivitamins that contain vitamin B12 and folic acid supplements. Improvement in counts will be gradual and may take up to two months.
The reticulocyte count, if increased within a period of 15 days, can yield a good outcome. If there is no rise in the reticulocyte count, then a vitamin B12 and folic acid serum assay will be necessary to rule out any malabsorption.
The erythrocyte sedimentation rate (ESR) is normal, and there are no abnormalities found in any of the cell lineages.

I hope this helps.

Answer 2

Hi,

Welcome back to icliniq.com.

In your dad's case, the cause is not related to nutrition. Other causes at the level of bone marrow need to be evaluated.

Please answer a few questions for detailed information.

Did he undergo any bone marrow biopsy recently?
Is there any rise in the reticulocyte count? An increase in this count will help in the good functioning of the bone marrow.
Since a few drugs can suppress the bone marrow, have you been taking any new medications for the past year?

Do kindly discuss with your doctor regarding the above tests and find a way to get to the cause. Till the main cause is identified, take the drugs prescribed earlier.

Please help.

Thank you.