What causes elevated WBC count?
Patient: I have had a WBC of 14,000 to 18,000 for the last 2 years taken every 3 months as my doctor says he's "watching it".  2 weeks ago my blood work came back with a slightly elevated (again, as usual) WBC of 14,000 , low granulocyte# (8.6 with the normal being 35-80 according to the blood work)  elevated monocyte# of 1.20.  What does that mean? Should I see a specialist?  I take 12.5 attenolol for SVT and ,625 Premarin and a multi vitamin. That's it,  Other than general fatigue and hot flashes- I don't feel sick really.  Just tired. Doctor: Hi,Thanks for asking.Based on your query, my opinion is as follows.1. Neutropenia with monocytosis and an elevated WBC count requires further evaluation. 2. Chronic infection is a strong possibility and correlation with ESR and CRP levels necessary.3. Further history necessary to identify possible cause. You should meet an internal medicine specialist.Hope it helps.Any further queries, happy to help again.