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What Do High ESR Level And Normal White Blood Cell Count Indicate?
Question: How can I have a high ESR (67), yet normal white blood cell count?
Brief Answer:
they are not related...
Detailed Answer:
Hello,
although there are certain disorders that cause both indices to rise (both the white blood cell count and the ESR) the two tests are not really related to each other. For example a patient with an autoimmune disorder may actually have lower white blood cell counts. A high ESR alone is not easy to approach diagnostically. More information is required to start a meaningful investigation. I'll be glad to comment on any detail you'd like to share.
I hope you find my comments helpful!
You can contact me again, if you'd like any clarification or further information.
Kind Regards!
they are not related...
Detailed Answer:
Hello,
although there are certain disorders that cause both indices to rise (both the white blood cell count and the ESR) the two tests are not really related to each other. For example a patient with an autoimmune disorder may actually have lower white blood cell counts. A high ESR alone is not easy to approach diagnostically. More information is required to start a meaningful investigation. I'll be glad to comment on any detail you'd like to share.
I hope you find my comments helpful!
You can contact me again, if you'd like any clarification or further information.
Kind Regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you. I was given ESR, TSH, CBC and CMP tests in response to a flare of pain which my dr. wonders if it was due to an inflammatory reaction in the body. Except for low creatine and an elevated ESR, nothing alarming has shown up in my blood tests. I assume that the low creatine is because I need to get in better shape.
I have well treated hypothyroid disease (TSH in normal range with medication and a thyroid nodule that has not grown larger with observation) and also well treated asthma, which is not bothering me at the moment.
I have had non specific abdominal symptoms with this pain, as well as itchiness and some minor hair loss. The pain was the driver in getting me to go to the dr.
My doctor is going to call with more info. and perhaps order more tests. In the meantime, I have been confused about the difference in the ESR and the WBC, as I thought inflammation has to do with white blood cells. I don't understand the inflammatory process in autoimmune diseases or arthritis.
Your reply did help me understand how the two tests could have different results.
I have well treated hypothyroid disease (TSH in normal range with medication and a thyroid nodule that has not grown larger with observation) and also well treated asthma, which is not bothering me at the moment.
I have had non specific abdominal symptoms with this pain, as well as itchiness and some minor hair loss. The pain was the driver in getting me to go to the dr.
My doctor is going to call with more info. and perhaps order more tests. In the meantime, I have been confused about the difference in the ESR and the WBC, as I thought inflammation has to do with white blood cells. I don't understand the inflammatory process in autoimmune diseases or arthritis.
Your reply did help me understand how the two tests could have different results.
Brief Answer:
the results do not help with the pain...
Detailed Answer:
Thanks for providing additional info.
The low creatinine is probably due to your body composition. More muscles cause higher creatinine and vice versa.
The high ESR could have been caused by various disorders including simple infections (even a bad tooth), autoimmune disorders, malignant disorders. The ESR reflects the tendency of red blood cells to stick to each other. When inflammatory molecules are present like fibrinogen, immunoglobulins, etc the ESR is high. Low albumins cause the ESR to get lower. During the course of infections the globulins rise, albumin is decreased and the ESR is rising.
The autoimmune diseases are caused by the body itself. The immune system attacks structures in the body (falsely not recognized as self) and this attack causes an inflammatory reaction and various symptoms. This is a broad idea of how autoimmunity works.
I can't give you an adequately documented explanation about your pain. I've seen in another questions you've asked that you had abdominal pain (right side). This kind of pain can be caused by gallbladder disease, renal colic, musculoskeletal problems, herpes zoster, etc. Clinical assessment is important to find the cause. When there is no clue for the cause a CT scan may provide additional (useful) information. Endoscopic assessment of the intestine is another potentially useful test.
Kind Regards!
the results do not help with the pain...
Detailed Answer:
Thanks for providing additional info.
The low creatinine is probably due to your body composition. More muscles cause higher creatinine and vice versa.
The high ESR could have been caused by various disorders including simple infections (even a bad tooth), autoimmune disorders, malignant disorders. The ESR reflects the tendency of red blood cells to stick to each other. When inflammatory molecules are present like fibrinogen, immunoglobulins, etc the ESR is high. Low albumins cause the ESR to get lower. During the course of infections the globulins rise, albumin is decreased and the ESR is rising.
The autoimmune diseases are caused by the body itself. The immune system attacks structures in the body (falsely not recognized as self) and this attack causes an inflammatory reaction and various symptoms. This is a broad idea of how autoimmunity works.
I can't give you an adequately documented explanation about your pain. I've seen in another questions you've asked that you had abdominal pain (right side). This kind of pain can be caused by gallbladder disease, renal colic, musculoskeletal problems, herpes zoster, etc. Clinical assessment is important to find the cause. When there is no clue for the cause a CT scan may provide additional (useful) information. Endoscopic assessment of the intestine is another potentially useful test.
Kind Regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you.
Brief Answer:
You're welcome!
Detailed Answer:
You're welcome! Glad to help...
You're welcome!
Detailed Answer:
You're welcome! Glad to help...
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Following up:
After reading a little about the ESR test, I am wondering if I can assume that a rate of 67 is not terribly elevated? The lab where my test was sent says that less than normal is 100 is a flag for certain things, and I'm below that point.
After undergoing tests a while back and going through physical therapy, I am pretty sure that my abdominal pain is just muscular-skeletal. Since my early thirties, though, I've had bouts with extreme fatigue, aching all over, and what I call "brain fog". Mouth ulcers and fevers used to accompany these bouts, but, happily, those don't bother me much anymore. But, I recently had a bout of the pain and fatigue that resulted in my having the test.
After reading a little about the ESR test, I am wondering if I can assume that a rate of 67 is not terribly elevated? The lab where my test was sent says that less than normal is 100 is a flag for certain things, and I'm below that point.
After undergoing tests a while back and going through physical therapy, I am pretty sure that my abdominal pain is just muscular-skeletal. Since my early thirties, though, I've had bouts with extreme fatigue, aching all over, and what I call "brain fog". Mouth ulcers and fevers used to accompany these bouts, but, happily, those don't bother me much anymore. But, I recently had a bout of the pain and fatigue that resulted in my having the test.
Brief Answer:
it's not terribly high
Detailed Answer:
I agree that this value is not terribly high. Values higher than 100 are always caused by serious disorders. So it's not a very important issue by itself but it's definitely abnormal. It could be a transient elevation for example due to infections. The bad thing about this test is that it's too broad to draw any conclusions.
Kind Regards!
it's not terribly high
Detailed Answer:
I agree that this value is not terribly high. Values higher than 100 are always caused by serious disorders. So it's not a very important issue by itself but it's definitely abnormal. It could be a transient elevation for example due to infections. The bad thing about this test is that it's too broad to draw any conclusions.
Kind Regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you.
Brief Answer:
you're welcome
Detailed Answer:
You're welcome.
Please don't hesitate to ask any further question you may have.
Kind Regards!
you're welcome
Detailed Answer:
You're welcome.
Please don't hesitate to ask any further question you may have.
Kind Regards!
Note: Do you have more questions on diagnosis or treatment of blood disorders? Ask An Expert/ Specialist Now
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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