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Low Netrophils (white blood) possible reaction to Asacol

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Ulcerative Colitis
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Posted 8/17/2015 12:35 PM (GMT 0)
Just recently my doctor picked up an alarmingly low white blood count & has advised that as it has dropped consistantly i will need to see a blood specialist for further treatment as it is in the danger zone. I have seen my GI & he seems confident that it is a reaction to Asacol so i have stopped my Asacol for a week on his instructions & had a blood test & he has advised me this will prove if it is my meds or not.

Has anyone else experienced this? My doctor is great & she picked it up due to my persistent infections. I am currently flaring & this is first time without Pres as i cant tolerate it anymore. I'm so over this, if it comes back it is my meds then another medication change!! I just cant seem to get a break.

Thoughts, kind words :-)
Posted 8/17/2015 3:28 PM (GMT 0)
Yes, Asacol (and other meslamine-based drugs) can cause a sudden dramatic drop in white blood cell counts. It's a rare side effect, but it does occur. Here's some information on it:

Asacol may cause low white blood cell count.
This drug may also cause the following symptoms that are related to low white blood cell count:

Agranulocytosis. This symptom may occur in people age 65 or older
Low counts of all blood cells including red and white blood cells, and platelets. This symptom may occur in people age 65 or older
Increase in neutrophile count

Source, and more details
doublecheckmd.com/EffectsDetail.do?dname=Asacol&sid=238&eid=2237

Good luck, it sounds like you're doing the right thing and stopping asacol.
Posted 8/17/2015 6:47 PM (GMT 0)
I have similar. It is call neutropenia. My dr.s from the Gastro, to Rheumatologist, to oncologist all agree it is from autoimmune disease rather than medicines. They also all agree that the meds make it worse. When I am on Humira, or Remicade the counts improve. I have had this since the 80's. I presently take self injections of neupogen when the counts get terrible. I was getting blood drawn every week to determine any pattern. At this point I am checking bloods every 8 weeks.
Posted 8/17/2015 9:31 PM (GMT 0)
Could also be from mesalamine, low B12, folate and copper deficiencies....
You were also on steroids. Lots going on at the same time makes it difficult to find the culprit.

Are you doing OK on the mesalamine, or still having issues UC-wise?

q
Posted 8/17/2015 10:25 PM (GMT 0)
Yes I recently had blood drawn which revealed neutropenia (the neutrophil count was 1). No one had bothered to do a CBC since last November when I began mesalamines--at that time they normal at 6. Saw my GI she advised I half my dose (from 4.8 grams to 2.4 daily). Within 3 days my count was up to 4. So it was definitely the mesalamine. I also agree with the fact that it could be low B-12 related, but that is due to the fact mesalamine depletes B and folate. In my case, I don't eat meat so that didn't help, however my neutros were fine when I began 5-ASA.
Posted 8/17/2015 10:34 PM (GMT 0)
Hi everyone :-) Thank you for the replies it always helps getting on here.

Quincy, i would say I'm not doing ok currently as i am in a flare and it is like one i have not experienced before. I have a new GI and when he first saw me he re - diagnosed me with UC + proctitis so i am being treated top and bottom. Even though I'm flaring since seeing him and being on this regime i have experienced the longest period in remission (4 mnths) sad i know. My doctor explained Neutropenia and she was really informative, she actually sis extra studies in blood disorders. Im just awaiting what next
? Im worried for the meds i will be on and the side effects, he mentioned Aziathiaprine and i looked at all the side effects and had to take deep breathes. I have just grown back my hair since i had half a head gone from prednisone.

This flare is being very stubborn and i have lost my job over my UC so now I'm jobless living alone with my parents paying my rent and bills :-( It started with debilitating back pain and left sided pain radiating to my whole abdomen, at the time this was all happening i was confused if it was the start of a flare because i had NO loose BMS or mucous / blood? however i was constipated ALOT. The hospital advised me it was constipation and my go had me start psillium husks and movicol daily. I got my system moving and then the week i stopped my maintenance meds (this past week) i started with my usual blood and mucous :-( Im now on colifoam twice daily (started 2 days ago) it has stopped blood but not much else, I'm still taking my suppository. My bladder always seems to flare up when on steroids or colifoam and i need to wee more than usual so i hate steroids.

Im a bit of a mess and to top it all off i have just met someone and I'm just wanting to be normal but have all this to deal with.

Sorry for the novel people, it looks like i needed a vent :-)

Post Edited (Indigo69) : 8/17/2015 4:37:32 PM (GMT-6)

Posted 8/18/2015 6:57 AM (GMT 0)
Go called, suspects after yest blood results it is from the Asacol, I'm reducing to 2g daily. Not sure why he isn't changing my meds, he said we will just closely monitor. Far out, i do feel at a loss here. I Google all medicines that can cause neutropenia and its like pretty much all the antibiotics i can tolerate.

So over it, just sick of this illness.
Posted 8/18/2015 4:42 PM (GMT 0)
Hi...I wrote a long response last night and lost it....didn't have time to come back to redo it (I was doing my prep for my c-scope I'll be having this afternoon).

I think reducing the Asacol is good start. If your numbers improve, then it'll be a hint as to the why.

I sure hope this gets figured out.

It's sad to hear about your job loss and financial issues...very difficult. It's wonderful your parents are able to be of financial support to you through this time. Are they equally supportive emotionally?

I can relate to the wanting to be normal....eventually we find our normal and continue on, but usually many changes are made along the way. Some our choice, others not.

I hope your new relationship grows, and that can be a helpful support (which you need).

Just to throw this out there...have you considered surgery? Not that it's an easy decision, but you do have a few issues that have possibly limited you to the meds you're able to take.

Hang tough...vent away. Everyone here has experience in one way or another that can hopefully answer questions and give support.

Keep us posted how you're doing with the med decrease.

q
Posted 8/19/2015 3:38 AM (GMT 0)
Hi Quincy

Thank you for the kind words, i am so very fortunate for the family i have as i often wonder how others cope without the added financial support. I am currently trying to look for work but is is hard when I'm trying to manage a flare. My mother and father are vey emotionally supportive and also financially. My mother carries a lot of the burden and i see that it upsets her at times as she feels the illness has taken away the fun loving girl i used to be and it is true i live in a state of fear even when I'm in remission.

I have asked the GI about surgery intact i practically begged and he told me i would not be a candidate as i have a lot of inflammation in the sigmoid colon also and he said this makes it hard?

I was up all night last night with bladder pressure which is a side effect for me to the colifoam because as soon as i stop using it I'm fine. This forum is the best place to come to get others thoughts, support and experiences.

I just started salafalk enemea today so i hope this kicks in soon as i will NEVER go on pred again as i will end up in the crazy persons ward….
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