DEAR DR. GOTT: What would cause a 50-year-old man to have an elevated white blood count?
DEAR READER: A high white count represents an increase in leukocytes, the disease-fighting cells that circulate in the blood. The condition is known as leukocytosis and usually indicates an infection, immune system disorder, medication reaction, or bone marrow disease.
There are a number of causes to consider such as stress– either emotional or physical, a bacterial or viral infection, the habit of smoking, an allergy, rheumatoid arthritis, damage to skin tissue such as from a burn, and the use of some prescription drugs such as corticosteroids and epinephrine. Then we get in to conditions such as leukemia, tuberculosis, polycythemia vera and a whole host of other possibilities.
Unless the individual to which you refer had a well-patient examination that included laboratory testing, it is likely the abnormality was detected because of symptoms experienced for which he initially consulted a doctor. Perhaps he lost his job or a loved one that caused great emotional stress, had a relatively minor bacterial infection, or was placed on a corticosteroid for a painful shoulder. The possibilities for an abnormality are endless.
It would be extremely helpful to know if there were any other abnormalities in his lab work that might shed some light onto his elevated white blood count. Were this information known, it certainly might help zero in on the possible cause.
I recommend the gentleman revisit his physician for repeat blood work. One reading alone isn’t enough to push the panic button. If we can use an automobile as a comparison, there are many conditions such as a simple tune up, spark plug replacement, or carburetor adjustment that can be made that will allow the individual to be back on the race track or in the game of life. However, if the condition continues, he and his physician should have a frank discussion regarding possible causes that could be more serious and which might mandate further investigation with X-rays, CT, MRI or other sophisticated testing. If questions remain and a cause cannot be readily identified, perhaps a referral to a hematologist/oncologist is in line. Be sure to bring all labs and X-ray results to allow either specialist a clear picture of what might be going on.
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