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Re: marked leucopenia

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,

>At this point I had stopped atovaquone weeks before, and was taking>doxy (400 mg), zith, and tini (2 g).

That's a fairly high dose combo of abx. The usual questions arise are your WBCs low bec of some toxic effect of the abx or as a result of INFECTED WBCs being dealt with? (I don't have the answer, I too had some WBC adventures, some before some during abx tx)

Which WBCs are low? neutrophils? lymphocytes? How are your platelets?

I would take an abx break too and maybe reintroduce them one at a time. Have you thought of cycling the tini into the combo in short bursts or are you already doing this?

Nelly

[infections] marked leucopenia

My whites have been at 3.6 - 3.7 for some months... I suspected thiswas the work of atovaquone. However I just got results from 2 weeks ago - 2.7 - pretty damn low.At this point I had stopped atovaquone weeks before, and was takingdoxy (400 mg), zith, and tini (2 g). Anyone know any resources on this? Its a bit concerning. I've donesome light googling and havnet found anything meaty.I think I'll have to take an abx break and see if I can get back somewhities here.

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Have a look at this site:

http://www.merck.com/mrkshared/mmanual/section11/chapter135/135a.jsp

It sounds like neutropenia is usually the culprit, when white counts

go down. So that neutrophils, specifically, are being used up but not

produced rapidly enough to make up the difference.

Should that show up in the differential portion of your CBC?

Your question interests me, I hope you'll get some more informed

replies.

> My whites have been at 3.6 - 3.7 for some months... I suspected this

> was the work of atovaquone.

>

> However I just got results from 2 weeks ago - 2.7 - pretty damn low.

> At this point I had stopped atovaquone weeks before, and was taking

> doxy (400 mg), zith, and tini (2 g).

>

> Anyone know any resources on this? Its a bit concerning. I've done

> some light googling and havnet found anything meaty.

>

> I think I'll have to take an abx break and see if I can get back some

> whities here.

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Interesting you bring this up now.

I obtained my records from 1994, 2003 and 2004. I had wanted

to know what my calcium was, and sure enough it is alway either

just under or just over the high number on the reference range

(suggestive of calcium dysregulation which I had suspected for

other reasons).

I never looked at my CBCs, until a couple of days ago.

Turns out my WBCs and platelets are consistently at the very low

end of the reference ranges (I don't have the numbers handy).

This paper:

http://tinyurl.com/bm6wh

PMID: 12764539

says leukopenia and thrombocytopenia are consistent with

ehrlichia, a point Dr. B makes in his ILADS review (though

apparently thrombocytopenia is less common than leukopenia

in ehrlichia infections).

This site:

http://www.emedicine.com/DERM/topic381.htm

says, leukopenia and thrombocytopenia are consistent with

sarcoidosis.

Matt

> My whites have been at 3.6 - 3.7 for some months... I

suspected this

> was the work of atovaquone.

>

> However I just got results from 2 weeks ago - 2.7 - pretty damn

low.

> At this point I had stopped atovaquone weeks before, and was

taking

> doxy (400 mg), zith, and tini (2 g).

>

> Anyone know any resources on this? Its a bit concerning. I've

done

> some light googling and havnet found anything meaty.

>

> I think I'll have to take an abx break and see if I can get back

some

> whities here.

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Thanks & Nelly.

I didnt get the differential (not yet anyway), but my neutros have

been worst in the past.

I had done the doxy with zith (and atovaquone) previously, when I was

up at 3.7, so I tend to suspect tini as the marrow toxin in this

instance. I have also seen dyscrasia listed as a possible tini side

effect. So I will take a break from that and get a new CBC.

Ive been doing tini continuously at 1.0 g bid. Ive been doing it a

little short of a month.

I dont think destruction of infected whites is a contributor: neutros

have about a 2-day lifespan and may have a yet-shorter circulating

life in blood; monocytes have only a few-day life in blood, tho they

can live for months once entering tissue and becoming mature macrophages.

Ive also started the AD mirtazapine since my last CBC, which could

mean my whites are even worse now! Alas, it seems quite a number of

ADs are not altogether innocent of dyscrasia.

> ,

>

> >At this point I had stopped atovaquone weeks before, and was taking

> >doxy (400 mg), zith, and tini (2 g).

>

> That's a fairly high dose combo of abx. The usual questions arise

are your WBCs low bec of some toxic effect of the abx or as a result

of INFECTED WBCs being dealt with? (I don't have the answer, I too had

some WBC adventures, some before some during abx tx)

>

> Which WBCs are low? neutrophils? lymphocytes? How are your platelets?

>

> I would take an abx break too and maybe reintroduce them one at a

time. Have you thought of cycling the tini into the combo in short

bursts or are you already doing this?

>

> Nelly

>

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My whites have also been low-ish or lower whenever measured during my

2-year course.

I have seen a few patient accounts of borderline/abnormal leukopenia

over at lymenet; I cant say to what degree any of them were natural

and/or iatrogenic (caused by medical treatment).

I had subnormal platelets way back when, at the time when I came down

with myoneuropathic pelvic pain. Ive seen reports of thrombocytopenia

all across immune disease land.

<mpalmer@u...> wrote:

> Interesting you bring this up now.

>

> I obtained my records from 1994, 2003 and 2004. I had wanted

> to know what my calcium was, and sure enough it is alway either

> just under or just over the high number on the reference range

> (suggestive of calcium dysregulation which I had suspected for

> other reasons).

>

> I never looked at my CBCs, until a couple of days ago.

>

> Turns out my WBCs and platelets are consistently at the very low

> end of the reference ranges (I don't have the numbers handy).

>

> This paper:

>

> http://tinyurl.com/bm6wh

>

> PMID: 12764539

>

> says leukopenia and thrombocytopenia are consistent with

> ehrlichia, a point Dr. B makes in his ILADS review (though

> apparently thrombocytopenia is less common than leukopenia

> in ehrlichia infections).

>

> This site:

>

> http://www.emedicine.com/DERM/topic381.htm

>

> says, leukopenia and thrombocytopenia are consistent with

> sarcoidosis.

>

> Matt

>

>

>

> > My whites have been at 3.6 - 3.7 for some months... I

> suspected this

> > was the work of atovaquone.

> >

> > However I just got results from 2 weeks ago - 2.7 - pretty damn

> low.

> > At this point I had stopped atovaquone weeks before, and was

> taking

> > doxy (400 mg), zith, and tini (2 g).

> >

> > Anyone know any resources on this? Its a bit concerning. I've

> done

> > some light googling and havnet found anything meaty.

> >

> > I think I'll have to take an abx break and see if I can get back

> some

> > whities here.

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:

Take a look at the absolute (ABS) numbers for the

White cells .

Are you neutropenic?

And if so have you always been that way?

Barb

> > ,

> >

> > >At this point I had stopped atovaquone weeks before, and was

taking

> > >doxy (400 mg), zith, and tini (2 g).

> >

> > That's a fairly high dose combo of abx. The usual questions arise

> are your WBCs low bec of some toxic effect of the abx or as a result

> of INFECTED WBCs being dealt with? (I don't have the answer, I too

had

> some WBC adventures, some before some during abx tx)

> >

> > Which WBCs are low? neutrophils? lymphocytes? How are your

platelets?

> >

> > I would take an abx break too and maybe reintroduce them one at a

> time. Have you thought of cycling the tini into the combo in short

> bursts or are you already doing this?

> >

> > Nelly

> >

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