High neutrophils, very low lymphocytes ?

[Alysia]

Hi. Thank you for being here ♡

I had my labs today. My neutrophils are always high but today they came even more, higher 10 points more then the usual high. The lymphocytes also came extremly low, much lower then the usual low. Closer to zero.

I always understand the high neutrophils and low lymphocytes as a reaction to pred and rtx. Is it correct ?

This time they are much extreme. I got rtx on January 3 and on March 31, 1000mg each time. Wg was flaring in the last months. It is less active but still smoldering: coughing, eyes still aching & red, ears aching only once a week now, less diarhea (but maybe because of strict diet), joints still aching (joints pains are like a lesson in anatomy, isn't it ? You say, oh here, I didn't know that there is a joint over there as well... ) .
Very tired all the time, aching all over. Every other day taking pain killers pills. Also itchy skin. Taking also fenystil drops every other day or so.

So, if the new extreme results reflect the activity of rtx, why do I still have wg symptoms ? Or maybe it reflects something else ??

P.s. I have a new symptom: when I am totally tired I feel my heartbeats in my chest. Not more fast or slow just more strong. Like the heart is jumping with force. The dr. Heard a heart murmur. I will do ECG tomorow and heart echo on Friday. The dr. Think that it is my broken heart. He knows that I miss my beautiful Phil. Can a broken heart become literaly so ?

I attach the labs. Hope it is clear enough. Sorry for the length of the post. I need my beautiful dr. Phil very much and this place still feels like it is his in a certain way.

Thanks ♡

Screenshot_2016-05-03-19-04-19.jpg

[Pete]

I can't really add anything by way of explanation. When I tried to enlarge the lab report, it became unreadable (on my phone). You may have something else going on. I hope your docs can figure it out. Good luck...

[Dirty Don]

Yes, a 'broken heart' can affect your health as much as anything else...it's the stress. I can hear my heart beat due to permanently enlarged Eustachian tube...causes an echo, can hear my heart beat, and the ocean is ever present! Hang tough kiddo...much love to you.

[crowneagle]

Alysia, mine are the same. High neutrophils low lymphocytes. What's your blood count? I believe that is more important. It would be worse if your neutrophils crashed. That would be neutropenia, which raises your risk of infection.

Hi. Thank you for being here ♡

I had my labs today. My neutrophils are always high but today they came even more, higher 10 points more then the usual high. The lymphocytes also came extremly low, much lower then the usual low. Closer to zero.

I always understand the high neutrophils and low lymphocytes as a reaction to pred and rtx. Is it correct ?

This time they are much extreme. I got rtx on January 3 and on March 31, 1000mg each time. Wg was flaring in the last months. It is less active but still smoldering: coughing, eyes still aching & red, ears aching only once a week now, less diarhea (but maybe because of strict diet), joints still aching (joints pains are like a lesson in anatomy, isn't it ? You say, oh here, I didn't know that there is a joint over there as well... ) .
Very tired all the time, aching all over. Every other day taking pain killers pills. Also itchy skin. Taking also fenystil drops every other day or so.

So, if the new extreme results reflect the activity of rtx, why do I still have wg symptoms ? Or maybe it reflects something else ??

P.s. I have a new symptom: when I am totally tired I feel my heartbeats in my chest. Not more fast or slow just more strong. Like the heart is jumping with force. The dr. Heard a heart murmur. I will do ECG tomorow and heart echo on Friday. The dr. Think that it is my broken heart. He knows that I miss my beautiful Phil. Can a broken heart become literaly so ?

I attach the labs. Hope it is clear enough. Sorry for the length of the post. I need my beautiful dr. Phil very much and this place still feels like it is his in a certain way.

Thanks ♡

Screenshot_2016-05-03-19-04-19.jpg

[annekat]

I can't enlarge your lab results at all on my old laptop. But I'm glad you brought this up, because I have always wondered about those, and my doc never says anything about them. I can't seem to find my lab reports right now, so will have to tell you later what the values for those two things are. I don't take RTX.

[MaxD]

Alysia,

The RTX effectively kills B cells (one of the two types of lymphocytes - B and T). So, depending on what the lymphocyte count is measuring, having low count may be expected with RTX treatment. Also, ANCA (the bad guys) are produced by plasma cells which are themselves produced by B-cells. ANCA are harmful because they make neutrophils clump into granulomas, essentially removing them from the blood stream and onto blood vessel walls. So perhaps high neutrophil and low lymphocyte may simply be RTX doing its job? See: https://www.rituxanforgpampa.com/about-rituxan-gpa-mpa-treatment/how-rituxan-is-thought-to-work.html

A common (often undiagnosed) risk of RTX is hypogammaglobulinemia (low gamma globulins), resulting in low immunity to infections. In my 3-monthly blood tests, my docs check for IgA, IgG, IgM (the immunoglobulin panel) to make sure I'm not too low. So far, I've been just below the low threshold but not enough for the docs to worry or treat for it. You may want to ask your docs about that in case you're down with some low-grade chronic infection. Also, if you tire quickly - check your hemoglobin (I'm sure it's in your tests, I couldn't read them).

Good luck with the ECG tests. You have people cheering for you.

[mishb]

I'm so glad you are getting the tests done to check the heartbeats. As I have said previously, it's better to be safe than sorry.
Or. better to know, one way or another.

I also believe that, this time, the double dose of RTX is doing the trick and has knocked those B cells out of the park, or for a six, as we Aussies say.
Fingers crossed that this is so

Take it easy lovely lady

[Alysia]

Yes, a 'broken heart' can affect your health as much as anything else...it's the stress. I can hear my heart beat due to permanently enlarged Eustachian tube...causes an echo, can hear my heart beat, and the ocean is ever present! Hang tough kiddo...much love to you.

Thank you so much, Don. I missed you.. your friendship is dear to my heart..

I don't hear my hear beats through the ears but feel them in the chest. like drums in the chest.
EKG was ok today. echo will be on Friday.

[Alysia]

Alysia,

The RTX effectively kills B cells (one of the two types of lymphocytes - B and T). So, depending on what the lymphocyte count is measuring, having low count may be expected with RTX treatment. Also, ANCA (the bad guys) are produced by plasma cells which are themselves produced by B-cells. ANCA are harmful because they make neutrophils clump into granulomas, essentially removing them from the blood stream and onto blood vessel walls. So perhaps high neutrophil and low lymphocyte may simply be RTX doing its job? See: https://www.rituxanforgpampa.com/about-rituxan-gpa-mpa-treatment/how-rituxan-is-thought-to-work.html

A common (often undiagnosed) risk of RTX is hypogammaglobulinemia (low gamma globulins), resulting in low immunity to infections. In my 3-monthly blood tests, my docs check for IgA, IgG, IgM (the immunoglobulin panel) to make sure I'm not too low. So far, I've been just below the low threshold but not enough for the docs to worry or treat for it. You may want to ask your docs about that in case you're down with some low-grade chronic infection. Also, if you tire quickly - check your hemoglobin (I'm sure it's in your tests, I couldn't read them).

Good luck with the ECG tests. You have people cheering for you.

Thank you for this wonderful explanation and for the good link. I can see from it why my body is aching all over.
then, I guess it means that the rtx is already working. it means that I can expect to feel better soon. this is what Michelle also says. I will try to post the lab results in a different way.... my hemoglobin is low. maybe some things that I feel are not wg but other issues like the lack of enough Iron and aching all over from the rtx.

[Alysia]

Thank you from the bottom of my heart, Pete, Don, Tom, Max, Anne, Micelle and all the others. I feel better today just because I have you. I love you ♡
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