6 mp - Elevated White Blood Cell Count & Liver Enzymes

OK... so I have been in the midst of a very stubborn flare since August 2009.  I have been on 100 mg of 6 mp since January and it is working for me.  I am now in remission (finally!).  I have felt better than ever the last few weeks.

The bad news is that my GI just called and said my latest bloodwork is bad - high white blood cell count and elevated liver enzymes.  I am to stop taking the 6 mp immediately, have my blood drawn again next week, and we will take it from there.

Beyond being exasperated...  I am worried about the elevated count and enzymes.  I know many of you have experienced this.  Did your white blood cell count and liver enzymes go back down once you stopped taking the 6 mp?

Thanks!

My liver enzymes were elevated about two months into using azathioprine. I was immediately taken off the drug and retested in a month. Everything was pretty much back to normal then.

I just read my actual report, and my white blood cell count is LOWER, not higher. The nurse said higher before she put me through to the Dr. but that was obviously incorrect. Sorry about that. My WBC is at 1000.

     My white blood count dropped to 1.6 last summer when I was on 100 mgm of 6MP.  My bilirubin was twice the normal.  Didn't you feel ill at all?  I felt like crap, no pun intended.  Doctor took me off the 6MP for a few months.  My blood tests returned to normal and he tried placing me back on 50 mgm.  I was taking 50 mgm for several years, but after the first two years of remission I started flaring yearly and then more often.  Two weeks before starting Remicade, last Nov, the doctor took me off the 6MP.  Remicade failed after 3rd infusion.  Today I gave myself my second round of Humira injections....keeping my fingers crossed this works! 

Sorry to read that you've been fighting off complications, Expecting. You were doing well for a good while so I do hope your gastro can find a better med combo to secure your remission. How is Chase? (2 yrs-old in February, right ?) Did you meet Peety (also a female attorney) online here? I think she joined the forum while you were away, though. Let us know how you're doing as time/energy permit. Best wishes for you to get UC back under good control soon. / Old Hat (30 yrs with left-sided UC; presently in remission taking brandname Colazal)

expecting226:

Thanks for the information.  Again only your GI doc can give you the proper advice.  The stuff I am posting is just based on my experiences with UC.  Yes, your wbc is low but that can happen with 6MP.  Now that your off the counts will most likely normalize.  Your Liver enzymes, you should be referring to ALT and AST which are commonly tested.  There normal values are 0-40 depending on the lab you are using.  The other liver tests most commonly used are the bilirubin and the alk/phos for which the normal values are typically 40-120.  So if I understand correctly your liver values are just out of the normal range.  I talked extensively with my GI doc and he really only worries about the liver when the values are around 100 for the ALT and AST.  So I think your doc just took you off because of the low wbc which will come back.  Then he just might put you on a lower dosage.  Your liver is not out of whack so just relax.  Again your GI doc is the best person to talk to but this is my opinion.

MyUC

Hey Expecting,

How's the liver looking? I was just browsing the web when I ran into this same issue. I'd been on all kinds of meds (Pred tapers, handfuls of Asacol, Meselamine enemas, sulfasulazine (sp?)... that nuked my system pretty bad...), doctor finally recommended 6MP. I'm off of everything else now and have been on a 50 mg dose for a while (a few weeks)with a pred taper. After the pred was gone, the stomach stayed ok (not perfect again, but much better than it has been in about 5 years). Upped me to 100mg, and yesterday my blood tests came back with liver warning signs (ALT about 130 and AST around 90).... he's not going to take me off compeltely, just put me back at 50mg and see if it settles down over the next couple of weeks. God I hope so, this has seemed to be the miracle drug for me, would hate to have to consider surgery to fix my UC..... I had been in a constant flare for about 5 years, was glad to finally be rid of it. Having 1-2 BMs a day is such a relief after 5 years of always tracking down every bathroom in any new building before being able to do anything else....

Anyways, let me know how you're feeling now, and if they still have you on the 6MP. I'm just looking for some good news, :-D

-Matt