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Leukocytosis: causes, symptoms and treatment

Often enough from doctors you hear: "You have signs of leukocytosis in your blood." It is often difficult for a patient to understand medical terms and understand what they mean. And various thoughts come to mind, sometimes not the best.

What it is? Leukocytosis is a secondary reaction of the hematopoietic system to a causative factor. It is to increase the level of leukocytes in the blood. The diagnostic threshold for adults is 10,000 cells in 1 μl of blood. However, there is one exception to the rule.

If a patient initially has a low level of leukocytes in the range of 3,000-5,000 per μl, then the state of leukocytosis is diagnosed at a level of 8,000-9,000 cells or more in 1 μl.


Causes of leukocytosis + risk factors


The causes of leukocytosis in the blood can be physiological and pathological. In the first case, we are not talking about the disease. This is a normal increase in bone marrow function, observed in certain age periods or associated with a particular condition. Physiological leukocytosis can be of several types:

  • The neonatal period. Immediately after birth, the level of leukocytes in a child’s body ranges from 9,000 to 30,000 / μl. In a week, their number decreases to 5,000 - 25,000 / μl. In some cases, children may experience prolonged leukocytosis, in which even at 13 years old, the number of these cells is 13,000 / μl (without any signs of disease in the body).
  • Digestive - increased leukocytosis after 2-3 hours after eating, and the more abundant it was, the higher its level. For this reason, a blood test is recommended to take on an empty stomach or at least 3 hours after the last meal. Otherwise, the likelihood of overdiagnosis and unwarranted treatment increases.
  • Myogenic, associated with the contraction of muscle cells. Therefore, before taking a blood test, it is necessary to eliminate intense physical exertion.
  • Psychoemotional.
  • Orthostatic, observed when changing positions from horizontal to vertical.

The causes of pathological leukocytosis can be both infectious and non-infectious. Its development is caused by 2 main mechanisms:

  1. Activation of myeloid and lymphoid germ blood as a result of the action of certain substances.
  2. Increased release of leukocytes from the bone marrow into the general circulation. Normally, not all educated blood cells immediately enter the bloodstream. In the bone marrow there is a cellular reserve, which is urgently consumed under conditions of increased need, for example, when an infectious agent enters the body.

The most significant stimuli for the activation of the hematopoietic function of the bone marrow with an increase in the level of white blood cells are:

  • bacterial toxins and enzymes;
  • decomposition products of cells and tissues;
  • hormones (adrenocorticotropic hormone, adrenaline and norepinephrine, glucocorticoids, ie stress hormones, have a stimulating effect)
    biologically active compounds, among which colony-stimulating factors are particularly relevant.

In a separate category is to distinguish medicinal leukocytosis. It is associated with the intake of certain pharmacological drugs, most often from the group of adrenergic mimetics.

This increase in leukocytes in the blood is due to redistributive mechanisms. However, long-term use of these drugs can lead to increased activity of bone marrow hematopoiesis.

Types of leukocytosis are classified depending on which cell level is elevated. From this point of view, there are:

  • neutrophilic
  • eosinophilic
  • basophilic
  • lymphocytic
  • monocytic
  • mixed forms in which there may be an increased content of some cells and reduced others, as well as an increase in both types of cells.

By leukocytosis in medicine is meant an increase in the number of leukocytes in the blood only. But some doctors call this term leukocyte elevation in any biological media, for example, in vaginal secretions, urine, etc. However, it is not correct to talk about leukocytosis in a smear or in the urine.

Symptoms of leukocytosis

Symptoms of leukocytosis

As a rule, leukocytosis is indicative of acute diseases, less often it can be observed in chronic pathologies. It is always a secondary syndrome caused by a causative disease. Depending on the type of the latter, a clinical picture will be formed.

Specific manifestations for leukocytosis does not exist. However, the symptoms of leukocytosis are directly dependent on the cellular characteristics. Therefore, it is important for the physician to identify which cells exceed the standard values ​​— neutrophils, lymphocytes, eosinophils, or others.

So, neutrophilic leukocytosis indicates:

  • Bacterial infections with a tendency to purulent inflammation (most often their causative agents are staphylococci, streptococci and meningococci).
  • Transferred blood loss.
  • Acute hemolysis (acute destruction of red blood cells).
  • Malignant tumors.
  • Hypoxia (lack of oxygen saturation in the body).
  • Intoxication that develops when the functioning of the internal organs is disturbed (for example, uremic intoxication in case of kidney diseases).
  • Pain injury.

An important diagnostic symptom is a shift to the left in leukocytosis. It allows you to evaluate its degree. This criterion is the ratio of the number of all segmented neutrophils (functionally mature cells) to non-segmented nuclei (young forms that practically do not perform immune functions). The normal value of this index is 0.06 - 0.08.

Based on this indicator, you can determine the prognosis of the causative disease. If the index is 0.25 - 0.45, then this corresponds to the regenerative type of changes in which the prognosis is favorable.

At the same time, a large number of stab neutrophils appear in the blood. Severe infections with a tendency to generalization and the development of purulent-septic complications correspond to the hyperregenerative index (1.0-2.0). The prognosis in this case is unfavorable. Young forms and their precursors (metamyelocytes) appear in the blood, which cannot perform immune functions.

A serious symptom is the presence of myeloblasts on the background of high levels of white blood cells. This may indicate acute leukemia (tumor of the hematopoietic system). Less commonly, it may be a sign of a severe purulent-septic state in which the leukemoid reaction develops.

Laboratory symptoms of neutrophilic leukocytosis include not only counting the number of white blood cells, but also determining their morphology. Its change in the form of degenerative signs is observed in the case of a strong influence of infectious-toxic factors. At the degeneration indicate such signs as:

  • the presence of grain inside the cell (in the cytoplasm);
  • kernel fragmentation;
  • the appearance of vacuoles;
  • cell shape change (spiked neutrophils appear, “bitten”, etc.).

All these changes are indicated by the laboratory assistant in the form of a blood test, if he identifies them. For the doctor, such signs greatly facilitate the compilation of a diagnostic search program.

Another option for leukocytosis is to increase the level of eosinophils more than 5% (eosinophilia). Most often it is regarded as a sign of an allergic process. Therefore, in the clinical symptoms there are manifestations of one of the following diseases:

The main symptoms of an allergy that a person can independently detect are:

  • itchy skin rash;
  • suffocation;
  • eye redness;
  • sneezing;
  • mucous nasal discharge, etc.

In some cases, eosinophilic leukocytosis indicates helminthic invasion (helminthiasis). Therefore, along with a laboratory sign, there are characteristic clinical manifestations: poor appetite, itching in the perianal area, weight loss and skin rash, etc.

Sometimes with eosinophilia, there may be symptoms of more rare diseases:

  • autoimmune (they are characterized by the fact that leukocytes begin to damage the body's own cells);
  • Hodgkin's disease;
  • myeloid leukemia with a chronic course.

The elevation of basophils in the blood in most cases is a rarely diagnosed condition, since the proportion of these cells in the leukocyte formula is insignificant (from 0.5% to 1%). Basophilia can occur with diseases such as:

  • myxedema - swelling of tissues associated with a deficiency of thyroid hormones;
  • non-specific ulcerative bowel disease;
  • allergic reactions;
  • erythremia (tumor, the source of which are the precursors of red blood cells);
  • chronic myelolecosis.

Monocytosis is a condition in which the number of monocytes in the blood is more than 8%. Monocytic leukocytosis may indicate some specific infections and cancers:

  • bacterial infections - septic endocarditis, tuberculosis;
  • Infectious mononucleosis;
  • sarcoidosis ;
  • systemic inflammatory connective tissue diseases;
  • tumors of the ovaries and mammary glands at the beginning of recovery in women who had no granulocyte leukocytes (neutrophils, basophils and eosinophils), ie in this case, monocytosis is a prognostically favorable factor.

Determination of peripheral blood lymphocytosis (more than 35%) is accompanied by a variety of clinical symptoms, because The list of causative diseases is huge. Most often it is:

  1. Some chronic and acute infections - whooping cough, hepatitis, infectious mononucleosis, tuberculosis
  2. Malignant tumors - lymphosarcoma, lymphocytic leukemia
  3. Endocrine diseases - adrenal insufficiency, increased functional activity of the thyroid gland
  4. Lack of vitamin B12 and folic acid. Unlike inflammatory diseases, the ESR is not increased in this causal condition. Leukocytosis (lymphocytic) is combined by neutropenia (a decrease in the number of neutrophils).

Leukocytosis in children

In addition to the above physiological leukocytosis, children may experience an increase in the level of eosinophils with prematurity, as well as in full-term children up to 3 months of age. This is regarded as a variant of the norm.

In other cases, it is necessary to look for the cause of leukocytosis (an increase in the level of leukocytes above the age norm). They, like adults, may be different:

  • infectious;
  • hormonal;
  • oncology;
  • allergic, etc.

The principles of diagnosis in pediatrics are similar to those in therapy. They are based on the fact that each type of white blood cells is responsible for a certain link in the immunity. Therefore, the cellular composition of the blood test helps to establish a preliminary diagnosis.

A follow-up survey is directed either to confirm it, or an exception.

Leukocytosis during pregnancy

Leukocytosis during pregnancy in the blood, developing in the second half, is a variant of the norm. Its appearance is due to 2 main mechanisms:

  1. Redistribution of blood in the body;
  2. Activation of the formation of leukocytes (leukopoiz) in the bone marrow.

This feature must be taken into account by doctors of different specialties in order not to prescribe unreasonable examinations, which supposedly should reveal the cause of this condition.

If a woman feels satisfactory and the gestation period is more than 20 weeks, and elevated leukocyte counts are found in the blood, then further diagnosis is not indicated.

Treatment of blood leukocytosis

Treatment of blood leukocytosis

The treatment of leukocytosis always depends on the underlying disease. There is no therapeutic agent that directly reduces the number of white blood cells. Therefore, careful diagnosis is always required.

Most often, leukocytosis is a sign of infection, therefore, the most common treatment is antimicrobial (antibacterial or antiviral) and anti-inflammatory.

Allergic leukocytosis can be treated with non-hormonal drugs (histamine receptor blockers, etc.) and hormonal (corticosteroids). Usually start with the first, and if they are not effective, then connect hormones.

Tumors of the blood system, in which leukocytosis appears, is an indication for polychemotherapy. It involves the use of cytostatics, which have a detrimental effect on uncontrollably dividing cells. Usually requires a combination of drugs from several groups.

What is dangerous leukocytosis?

The answer to the question of how dangerous leukocytosis depends on the underlying disease that led to this hematological syndrome. The main complications can be:

  • purulent-septic - abscess, phlegmon, etc .;
  • peritonitis (inflammation of the peritoneum);
  • metastasis of malignant tumors;
  • development of immunopathological diseases ( systemic lupus erythematosus , dermatomyositis, etc.).

Basophilic leukocytosis may indicate a poor prognosis for a patient with hematologic disease. The appearance of basophils in the blood of more than 1% (the norm of 0.5 - 1%) indicates an increased risk of end-stage leukemia.


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