Leukocytosis

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Leukocytosis
What Is Leukocytosis?

Leukocytosis is an increased number of leukocytes, or white blood cells (WBCs), in the blood. The WBCs
are the blood cells responsible for the immune response, the fighting of infection. There are many
different kinds of WBCs, each with their own particular function. WBCs are produced in the bone
marrow, circulate for a time in the blood, and leave the blood to perform their function in the tissues.
WBC levels may increase due to increased marrow production or decreased exit from the blood to the
tissues.

Neutrophilia

Neutrophils are WBCs that move from the blood into the cells to kill invading bacteria and fungi. If
neutrophil levels become too high, neutrophilia results. Neutrophilia is the most common form of
leukocytosis. In a bacterial or fungal infection, more neutrophils are produced to fight the disease.
However, there are many other causes of neutrophilia.

Among the causes of neutrophilia are infections (i.e. bacterial or fungal infections or tuberculosis),
inflammatory diseases such as rheumatoid arthritis, and loss of blood cells through bleeding or
hemolysis (destruction of blood cells). Elevations in hormones (such as adrenocorticosteroids and
epinephrine) or steroid medications such as Prednisone may also increase neutrophil production. Other
causes include cold, heat, exercise, seizures, pain, labor, surgery, panic, and rage. In addition,
myeloproliferative disorders, causing proliferation of bone marrow cells, and cancer may also cause
neutrophilia (for more on these, please see Myeloproliferative Disorders and Leukemia.

Symptoms of neutrophilia are usually the result of the underlying problem, such as signs of infection,
bleeding, or bone marrow disorder. The disorder is diagnosed by patient history, physical examination
for symptoms, and laboratory testing. The goal of diagnosis is to detect elevated neutrophil levels and to
determine the cause of this problem. Treatment focuses upon addressing the underlying disorder or
disease.

Eosinophilia and Basophilia

Eosinophils and basophils are WBCs involved in allergic reactions. When these cells increase in the body,
eosinophilia and basophilia result. Common causes of eosinophilia include allergic reactions, skin
disorders, parasitic infections, myeloproliferative disorders (leukemia, polycythemia vera,
myelofibrosis), and other cancers. Basophilia is less common and is usually a symptom of
myeloproliferative disorders or hyperthyroidism. The disorders are diagnosed by patient history,
physical examination, and laboratory testing. Treatment attempts to address the underlying problem.
For allergic reactions, antihistamines may be used to relieve allergic symptoms.

Monocytosis
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Monocytes, like neutrophils, destroy bacteria and fungi in the cells. When monocyte levels in the blood
become elevated, monocytosis results. Infections which may cause monocytosis include bacterial
infections , protozoal infections such as malaria, rickettsial infections, and tuberculosis. In addition,
diseases (such as ulcerative colitis, regional enteritis, sarcoidosis, and connective tissue disorders) and
cancer (especially lymphomas and leukemias) may cause monocytosis. Diagnosis and treatment involve
finding the underlying cause and, if possible, addressing it.

Lymphocytosis

The lymphocytes are a group of cells that fight viral and bacterial infections and other foreign material
that may enter the body. Each type plays a specific role in immunity. In lymphocytosis, the level of
lymphocytes in the blood increases. Lymphocytosis may result from most bacterial infections, infectious
mononucleosis, or cancers such as leukemia or non-Hodgkin’s lymphoma. Symptoms include enlarged
spleen and lymph nodes and the symptoms of the underlying infection or disease. Diagnosis and
treatment involve patient history, physical examination, laboratory testing to identity cause, and
treatment of underlying cause.

The Leukemoid Blood Picture

Leukemoid blood picture refers to an increased number of leukocytes, or white blood cells (WBCs). It is
caused by increases in the number of precursor cells that will eventually grow into mature WBCs. This
may occur in infections, bleeding from the digestive tract, cancer, or destruction of red blood cells in the
blood (hemolysis; see Anemia). This is diagnosed based on patient history, physical examination, and
laboratory examination for extensive bleeding and blood cell destruction.

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