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What Causes Low White Cell Count With Recurrent Bronchitis?
Question: I am Asian from Vietnam and have a common Asian disease in which I have very low white blood cell count always. I took an allergy skin test and almost all the results were normal. However, I get bronchits every 6 weeks and have so so much phlem I cough up for 3 or four minutes at a time which is green in color. I take antibiotics like Z-pack and expectorant three times a day and get better by spitting the phlem out. Then two weeks later after I was so much better, the bronchitis comes back and my white phlem I cough up becomes green again. I then get pnenmonia. So, because of my low white blood cell count disease I have I guess my immune system is not very strong, I do take Vitamin C every day but I get bronchitis or pnemonia every 6 weeks and the antibiotic only help for two weeks then I get sick again. I don't want to need antibiotics every 6 weeks because I might have them stop working over time.Should I take expectorant everyday (3 pills a day) to help me cough up the phlem so it does not get stuck in my lungs and become bronchitis or pnemonia; is three pills a day enough or would 4 pills of expectorant cause some type of bad side effect, what side effect? What can I do or what med can I take to make my white blood cell count higher, or to make my immune system stronger?
Brief Answer:
3 plausible causes of your symptoms
Detailed Answer:
Hello
I am Dr.Omer and I am here to help you with your query.
I am Sorry to hear about your recurrent bronchitis.
As you have said in your query that you have low white cell count with recurrent bronchitis ( green to white phlegm ).
Combining these two symptoms show us that you have immune/blood problem.
Based on the information given by you following are the plausible causes:
1. Cystic fibrosis can start in 30s , in which there is dilatation of the bronchioles of the lung which causes recurrent bronchitis with copious amount of phlegm and low white cells. Cystic fibrosis is a genetic disease.Investigation required is sweat test and Ct scan of lung.
2. Alpha 1 anti-trypsin is also a genetic disease presents with low white cells and recurrent bronchitis , common in smokers , test is genetic testing for alpha-1-anti-trypsin.
3. HIV infection is common in asian people , aggravated by social contact with people in Vietnam.It may present with recurrent bronchitis with low white cell count.HIV also causes pulmonary tuberculosis which in-turn causes recurrent bronchitis , fever , weight loss and lymphadenopathy.For TB CT scan lung , montoux test and ESR will show IF its there.For HIV you need to do RT-PCR to see the viral load.
Musinex is guaifenesin , maximum dose is 2.4 gram /day.If you are taking 400-600 mg , then you can repeat after 8 hrs.
With high dosage i.e beyond 2.4 gram/day can cause kidney stones , dizziness , headache with vomiting.
Vitamin C cannot cause increase in white cells until and unless we treat the underlying cause of low white cells as i have explained above.
In the end i would say that you should review your problem with an Internist as he will do the above tests to rule out these diseases discussed above.
Do not worry as all the diseases i told are completely treatable.
Feel free to ask any further queries.
Take care
3 plausible causes of your symptoms
Detailed Answer:
Hello
I am Dr.Omer and I am here to help you with your query.
I am Sorry to hear about your recurrent bronchitis.
As you have said in your query that you have low white cell count with recurrent bronchitis ( green to white phlegm ).
Combining these two symptoms show us that you have immune/blood problem.
Based on the information given by you following are the plausible causes:
1. Cystic fibrosis can start in 30s , in which there is dilatation of the bronchioles of the lung which causes recurrent bronchitis with copious amount of phlegm and low white cells. Cystic fibrosis is a genetic disease.Investigation required is sweat test and Ct scan of lung.
2. Alpha 1 anti-trypsin is also a genetic disease presents with low white cells and recurrent bronchitis , common in smokers , test is genetic testing for alpha-1-anti-trypsin.
3. HIV infection is common in asian people , aggravated by social contact with people in Vietnam.It may present with recurrent bronchitis with low white cell count.HIV also causes pulmonary tuberculosis which in-turn causes recurrent bronchitis , fever , weight loss and lymphadenopathy.For TB CT scan lung , montoux test and ESR will show IF its there.For HIV you need to do RT-PCR to see the viral load.
Musinex is guaifenesin , maximum dose is 2.4 gram /day.If you are taking 400-600 mg , then you can repeat after 8 hrs.
With high dosage i.e beyond 2.4 gram/day can cause kidney stones , dizziness , headache with vomiting.
Vitamin C cannot cause increase in white cells until and unless we treat the underlying cause of low white cells as i have explained above.
In the end i would say that you should review your problem with an Internist as he will do the above tests to rule out these diseases discussed above.
Do not worry as all the diseases i told are completely treatable.
Feel free to ask any further queries.
Take care
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Dear Dr. Omer,
I have a Cat scan of sinus scheduled soon. I took z-pack extra strength antibiotic for 3 days then doxycycline for 10 days then had blood work done. My immunoglobulins quantitative results were out of normal range: IgG 2173, when normal is 694-1618; IgA was also high at 543 when normal is 81-463; I also had high IgM 356 when normal is 48-271. I will probably get bronchitis or pnemonia in 4 or 6 more weeks since I am now off the antibiotics. I still take expectorant (Musinex brand). I do not smoke and HIV test was normal. Two questions please: 1). What do these test results mean? (if I also usually have very low white blood cell count.)
2). Also, do you have any medications for me to consider asking my doctor about my immuno problem other than expectorant (musines/guanfacin) 400mg 3 times a day).
Thank you!
I have a Cat scan of sinus scheduled soon. I took z-pack extra strength antibiotic for 3 days then doxycycline for 10 days then had blood work done. My immunoglobulins quantitative results were out of normal range: IgG 2173, when normal is 694-1618; IgA was also high at 543 when normal is 81-463; I also had high IgM 356 when normal is 48-271. I will probably get bronchitis or pnemonia in 4 or 6 more weeks since I am now off the antibiotics. I still take expectorant (Musinex brand). I do not smoke and HIV test was normal. Two questions please: 1). What do these test results mean? (if I also usually have very low white blood cell count.)
2). Also, do you have any medications for me to consider asking my doctor about my immuno problem other than expectorant (musines/guanfacin) 400mg 3 times a day).
Thank you!
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