instruction: hi doctor can fluctuate blood pressure cause elevated abc I got sick with chronic idiopathic urticaria and started mtx my rheumatologist diagnosed me with seronegative ra and stopped mtx did vectra da test and scored 42 moderate for ra disease I was supposed to start remicade this thursday but my blood pressure started fluctuating as high as 189 108 mhg to 138 83 mhg with low he as low as 43 at rest in er they checked heart lungs and kidneys they referred me to a cardiologist and she added a new medicine edarbi 40 my but said abc is 20 with polls 93 and lymph 5 I was referred to a hematologist he said that it looks to be some bone marrow abnormalities and suggested more extensive blood tests to see if reactive effect to inflammation or blood disease or cancer the other symptoms are weakness fatigue and intermittent slight shortness of breath but I suspected all was due to pressure or heart rate issue fever chills and body ache lasted for one day I was fine after I took 500 my naproxen there is no cold symptom with fever I saw my rheumatologist and she said it is not ra related based on high polls cop ranged from 2 to 17 earlier that is before two years and now almost at its lowest at does this look like a body reacting to inflammation or pressure or heart rate also I have intermittent pain in lower left abdominal area I do not see my hematologist for follow up until next month and cannot start remicade until I get it figured out
output: hi thank you for providing a detailed history to answer your first query there is no direct correlation between fluctuating be and the increase in cell counts cop is usually elevated in ra rheumatoid arthritis disease which is a common finding reflecting the body reaction to inflammatory or autoimmune disorders like ra though your be is now controlled to some extent the low pulse rate could be because of systolic my nebivolol you need a review with your cardiologist for the same also looking at your non specific symptoms like weakness fatigue intermittent shortness of breath fever chills along with elevated differential white cell counts it is advisable to have bone marrow examination done to rule out hematological malignancy I am not convinced with your or of 98 have you checked it correctly please update thank you bone marrow aspiration review with cardiologist and hematologist