Seeking Clarity on Low White Blood Cell Count: Should I Be Concerned?
Greetings to all! I am reaching out to understand whether it’s appropriate for me to take charge of my healthcare decisions or if my concerns are unfounded and typical. To give some background, my journey with primary care has been quite fragmented due to frequent relocations and changing insurance. Consequently, my complete CBC (Complete Blood Count) results are scattered across different medical providers. I’m a 24-year-old female, standing at 5'5" and weighing between 120 to 125 pounds. Time and again, I've expressed to my healthcare professionals that I often feel more vulnerable to illnesses compared to others. Sadly, my apprehensions have usually been downplayed. This has led me to accept my discomfort as normal and endure my ailments in silence. Recently, I reviewed my CBC results from the last three tests, and they uniformly reveal a low white blood cell count, a finding my doctor has overlooked. Here are the specific values from those tests: - 07/2025: White blood cell count: 3.6 (thousand/uL) - 10/2023: White blood cell count: 3.9 (thousand/uL); Absolute neutrophils: 1318 (cells/uL) - 10/2022: White blood cell count: 3.35 (k/uL); Granulocyte count: 1.2 (k/uL) Some health issues I have encountered include frequent urinary tract infections (multiple times per year), despite adhering to hygiene practices associated with sexual activity. Furthermore, I recently experienced hand, foot, and mouth disease as an adult. Initially, my physician dismissed it, claiming adults rarely contract it, yet soon after, I broke out in blisters, validating the diagnosis. This does not encompass other minor ailments, like a prolonged stomach virus that I just recovered from a month ago, which made even the scent of food nauseating. Am I simply imagining this? Are my white blood cell levels considered normal, and should I not be worried? Thank you in advance for any insights. I also wish to express my gratitude for my health (it certainly could be worse), and I tend to avoid medical visits due to my fear of needles and blood draws.
Answers (1)
7/3/2025, 12:40:51 AM
OpenHealth AI
It's understandable to feel concerned about a consistently low white blood cell count and the symptoms you've been experiencing. Your proactive approach to seeking clarity is commendable and is an important aspect of managing your health.
Understanding Low White Blood Cell Count
A low white blood cell count, technically known as leukopenia, can make you more susceptible to infections since white blood cells are vital for your immune system. Your values—ranging from 3.35 to 3.9 thousand/uL—are below the average normal range, typically considered to be 4.5 to 11.0 thousand/uL. While variations can occur, consistently low results warrant further attention.
Addressing Your Symptoms and Concerns
Your frequent illnesses, including urinary tract infections and a recent diagnosis of hand, foot, and mouth disease, contribute to a feeling of vulnerability. It’s crucial to connect your symptoms with the potential implications of your low white blood cell counts since they may indicate an underlying issue that should be explored further.
Next Steps
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Track Your Symptoms: Continue maintaining a diary of your symptoms, noting the frequency and severity of your infections and any other health changes. This information can be valuable for your healthcare providers.
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Reference Prior Results: Compile and organize your CBC results along with any relevant clinical notes from your past healthcare providers. Having a comprehensive record can facilitate future discussions with new medical professionals.
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Communicate Your Concerns: When you consult a healthcare provider, be direct about your past experiences and how you feel your concerns have been managed. Express the belief that your health issues merit further investigation into your low white blood cell count.
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Consider a Specialist: Given your symptoms and lab results, you might benefit from meeting with a hematologist (a blood specialist). They can evaluate your blood counts more closely and investigate any potential causes.
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Focus on Self-Care: Maintain a healthy lifestyle that supports your immune system. This includes balanced nutrition, regular exercise (as tolerated), staying hydrated, and getting enough sleep.
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Address Nervousness About Medical Visits: If the fear of needles and blood draws is impacting your healthcare engagement, consider discussing this with your doctor or a counselor. They may offer strategies to help alleviate this anxiety, making it easier for you to seek the care you deserve.
Recognizing your health needs is an important step, and being an advocate for yourself is vital. Your feelings are valid, and there’s nothing wrong with seeking more clarity and care. Thank you for sharing your journey; I hope these steps empower you to take the next actions for your health.
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - 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WBC: 5.8 × 10⁹/L (SHOWS IMPROVEMENT) - **RBC: 2.93 × 10¹²/L** (IMPROVED but still low) - **Hemoglobin: 72 g/L** (SHOWS IMPROVEMENT but still low) - Platelets: 223 × 10⁹/L (BACK TO NORMAL) - Neutrophils: 30.0% - Lymphocytes: 64.8% - Monocytes: 4.6% ### Biochemistry (January 28, 2026): - Total protein level: 67 g/L (slightly deficient) - Creatinine: 20.7 μmol/L - **Total Bilirubin: 242 μmol/L** (STILL HIGH - unchanged) - **Direct Bilirubin: 142 μmol/L** (VERY HIGH) - **ALT: 50 IU/mL** (DRASTICALLY LOWER from >1000!) --- ## OVERVIEW OF PROGRESS OVER 6 MONTHS | Parameter | August 2025 | January 2026 | Change | |------------------|-------------|---------------|--------------------------| | **Hemoglobin** | 69 g/L | 72 g/L | ↗ Slight improvement | | **RBC** | 2.1 | 2.93 | ↗ Improved | | **ALT** | >1000 | 50 | ✓✓ MAJOR IMPROVEMENT | | **Bilirubin** | 245 | 242 | → Unchanged (still elevated) | | **Portal vein** | 6.1 mm | 3.9 mm (US) | ↗ Decreased | | **Platelets** | 403 | 223 | ↘ Normalized | | **Shunt size** | 9.9 mm | 9.9 mm | → No Change | --- ## CURRENT SITUATION (February 2026 - 7 Months Old) - **Weight:** 9 kg (good growth rate in spite of condition) - **Jaundice:** Continues to be present (yellow skin) - **Stools:** Remain pale/clay-colored - **Development:** Achieving appropriate milestones - **Energy:** Appears to have a good energy level - **Feeding:** Normal appetite --- ## QUESTIONS FOR r/AskDocs We have been informed this is **Type 2 Abernethy malformation** (portal vein present). **Three treatment avenues have been proposed:** ### Option 1: **Endovascular Coil Embolization** (minimally invasive approach) - A catheter is inserted via the leg vein to access the shunt and deploy coils/plugs to close the abnormal vessels - Pros: No surgical incision, minimal discomfort, short hospital stay (2-4 days), no scars, enhanced safety - Duration: 1-2 hours - Recovery: 2-4 weeks for jaundice to show improvement ### Option 2: **Open Surgical Intervention** - An incision in the abdomen to ligate abnormal vessels and redirect blood to the liver - Pros: Direct visualization, effective results - Cons: Surgical scar, longer recovery time (7-14 days in hospital) - Duration: 2-4 hours ### Option 3: **Liver Transplantation** - We have been advised this is not necessary as the portal vein is functional and liver health is improving. --- ## SPECIFIC QUESTIONS TO CONSIDER: 1. **With a functional portal vein (6.1 mm) and improving liver function (ALT normalized), is it advisable to pursue endovascular closure as the preferred treatment?** 2. **Despite ALT levels improving, the bilirubin remains consistently high (242). Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. Seeking expert advice on optimal treatment strategy and timing.