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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Does Plaquenil Cause Anemia?

I have been diagnosed with pyelonephritis. I was given a round of Bactrim DS, a round of Levaquin, a round of Cipro. They started me on another round of Cipro but sent a culture out and obviously it came back as resistant. So after 4 weeks of fever spiking up to 102-103, I am on Macrobid, which culture shows it should be susceptible to. On my CBC, my WBC s are listed as 4.5 and my RBC s have gone from 12.8 to 10.9 in about 4 months. I have a call in to my Rheumatologists office, but am impatient and worried. I have a hysterectomy 5 years ago due to an ovarian mass, so heavy periods are not the culprit. Could Plaquenil cause the anemia or the low WBC count?
Tue, 26 Sep 2017
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General & Family Physician,  's  Response
Hello.
I understand your concern.

Your diagnosis goes for Anemia of inflammation.

From your description I realized that you maybe are suffering from rheumatic diseases, because Plaquenil is used to treat symptoms of rheumatic diseases.
A rare side effect of Plaquenil is decrease of White Blood Cells.

But in your case, the cause of anemia is pyelonephritis, because the level of HGB (Haemoglobin) before the pyelonephritis was started was in the norm,12.8g/dl . HGB after 4 weeks of high temperature fell to 10.9g/dl.

(I believe that numbers 12.8 and 10.9 refer to HGB, not RBC.)

When inflammation attacks the kidneys (which release a hormone that causes the marrow to make red blood cells), it can decrease the number of red blood cells produced, causing anemia.

I wish you fast recovery.
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Does Plaquenil Cause Anemia?

Hello. I understand your concern. Your diagnosis goes for Anemia of inflammation. From your description I realized that you maybe are suffering from rheumatic diseases, because Plaquenil is used to treat symptoms of rheumatic diseases. A rare side effect of Plaquenil is decrease of White Blood Cells. But in your case, the cause of anemia is pyelonephritis, because the level of HGB (Haemoglobin) before the pyelonephritis was started was in the norm,12.8g/dl . HGB after 4 weeks of high temperature fell to 10.9g/dl. (I believe that numbers 12.8 and 10.9 refer to HGB, not RBC.) When inflammation attacks the kidneys (which release a hormone that causes the marrow to make red blood cells), it can decrease the number of red blood cells produced, causing anemia. I wish you fast recovery.