Effect of low-dose prednisone on leukocyte counts | Arthritis Information

Natali B et al. - These results confirm an effect of corticosteroids on white blood cells (WBC) and neutrophil counts in patients with RA. However, low-dose prednisone regimens seem not to have a significant impact on circulating blood leukocytes. Therefore, in any RA patient being treated with low-dose prednisone, the appearance of leukocytosis or neutrophilia should warrant the search for other causes.

Methods

Study to assess the effect of low dose prednisone on WBC and neutrophil counts
157 consecutive pts with RA were receiving (n=91) or not (n=66) daily doses of oral prednisone
Average prednisone dose: 6.1 ± 2.7 mg
Inclusion criteria: age between 18-80 yrs, and disease duration ≥6 mo
Exclusion criteria - acute or chronic infectious processes or the presence of any of the following conditions within the 2 months prior to entry:
- diabetic ketoacidosis, hyperthyroidism, acute or subacute thyroiditis
- Cushing syndrome, pheochromocytoma, myeloproliferative or lymphoproliferative disease
- recent coronary disease events, trauma, use of lithium, beta adrenergic agonists, or intraarticular injection of corticosteroids
Venous blood samples read in a Coulter GEN-STM hematology analyzer with AccuGate software

Results

WBC and neutrophil counts were higher, whereas lymphocyte counts were lower in pts receiving oral prednisone
13/91 pts receiving prednisone vs 6/66 pts not receiving prednisone showed leukocytosis
After excluding this subgroup of pts with leukocytosis, pts on prednisone still showed higher number of WBC
No differences in the proportions of pts with or w/o neutrophilia in both groups
No differences in monocyte or eosinophil total counts
WBC or eosinophil counts did not correlated with disease activity or with the use of DMARDs
A direct correlation between prednisone dose and WBC total counts as well as neutrophil counts was seen
Multiple regression analysis: only prednisone dose was associated with higher leukocyte counts and higher neutrophil counts

http://journals.lww.com/jclinrheum/Citation/2009/04000/Effect_of_Low_Dose_Prednisone_on_Leukocyte_Counts.14.aspx