Leukocytosis

Leukocyte is another name for white blood cell (WBC). These are the cells in your blood that help your body fight infections and some diseases.

When the number of white cells in your blood is higher than normal, it’s called leukocytosis. This usually happens because you’re sick, but sometimes it’s just a sign that your body is stressed.is a condition that affects all types of white blood cells. Other illnesses, such as neutrophilia, lymphocytosis, and granulocytosis, target specific types of white blood cells. Normal white blood cell counts are 4,300-10,800 white blood cells per microliter. Leukocyte or white blood cell levels are considered elevated when they are between 15,000-20,000 per microliter. The increased number of leukocytes can occur abnormally as a result of an infection.An abnormally large number of leukocytes, as observed in acute infections, inflammation, hemorrhage, and other conditions. A white blood cell count of 10,000/mm3 (or more) usually indicates leukocytosis Most examples of leukocytosis represent a disproportionate increase in the number of cells in the neutrophilic series, and the term is frequently used synonymously with the designation neutrophilia. Leukocytosis of 15,000-25,000/mm3 is frequently observed in various pathologic conditions, and values as high as 40,000 are not unusual; occasionally, as in some examples of leukemoid reactions, white blood cell counts may range up to 100,000/mm3.Leukocytosis is usually a response to an infection or inflammation, so it’s not a cause for alarm. However, it can be caused by serious diseases such as leukemia and other cancers, so it’s important that your doctor diagnose the cause of an increased WBC when it’s found. Leukocytosis associated with pregnancy or in response to exercise is normal and nothing to worry about.

1. LEUKOCYTOSIS PRESENTED BY R.PRIYA

2. INTRODUCTION Leukocytosis is the broad term for an elevated white blood cell (WBC) count, typically above 11.0x10^9/L, on a peripheral blood smear collection. The exact value of WBC elevation can vary slightly between laboratories depending on their 'upper limits of normal' as identified by their reference ranges. The WBC value represents the sum-total of white blood cell subtypes, including neutrophils, eosinophils, lymphocytes, monocytes, atypical leukocytes that are not normally present on a peripheral blood smear (e.g., lymphoblasts), or any combination of these. The clinician should properly characterize the leukocytosis and determine if further evaluation and workup are indicated. The broad differential diagnoses of leukocytosis require evaluation beyond basic laboratory workup, and clinicians should be able to perform physical examinations and targeted histories to ascertain the possible causes of the presenting lab abnormality. To evaluate for these causes, careful histories, physical examinations, medication reconciliations, family histories, and the possible need for consultants for procedures (e.g., genetic testing, hematology/oncology consultations, infectious disease, etc.) must be completed depending on what is discovered

3. DEFINITION Normally you have between  4,000 and 11,000 WBCs per microliter  of blood if you aren’t pregnant. Anything higher is considered leukocytosis. WBC counts between 50,000 and 100,000 per microliter usually mean a very severe infection or cancer somewhere in the body. A WBC count over 100,000 most often occurs with leukemia or other blood and bone marrow cancer. Leukocytosis  is a condition in which the white cell ( leukocyte  count) is above the normal range in the  blood .

4. TYPES Leukocytosis is classified by the type of WBC that’s increased. The five types are: Neutrophilia.  This is an increase in WBCs called  neutrophils . They’re the most common type of WBCs, accounting for  40 to 60 percent  of WBCs. Neutrophilia is the type of leukocytosis that occurs most often. Lymphocytosis.  About  20 to 40 percent  of WBCs are  lymphocytes . An increased number of these cells is called lymphocytosis. This type of leukocytosis is very common. Monocytosis .  This is the name for a high number of monocytes. This cell type makes up only about  2 to 8 percent  of WBCs. Monocytosis is uncommon. Eosinophilia.  This means there are a  high number of cells called eosinophils  in blood. These cells make up about  1 to 4 percent  of WBCs. Eosinophilia is also an uncommon type of leukocytosis. Basophilia.  This is a high level of WBCs called  basophils . There aren’t many of these cells in blood — only  0.1 to 1 percent  of WBCs. Basophilia is rare. Each type of leukocytosis tends to be associated with a few conditions: Neutrophilia is associated with infections and inflammation. Lymphocytosis is associated with viral infections and  leukemia . Monocytosis is associated with certain infections and cancer. Eosinophilia is associated with allergies and parasites. Basophilia is associated with leukemia.

5. CAUSES Causes of neutrophilia: infections anything that causes long-term inflammation, including injuries and arthritis reaction to some drug such as steroids, lithium, and some inhalers some kinds of leukemia a reaction to emotional or physical stress from things like anxiety, surgery, and exercise having spleen removed smoking Causes of lymphocytosis: viral infections whooping cough allergic reactions some kinds of leukemia

6. CAUSES Causes of eosinophilia: allergies and allergic reactions, including  hay fever  and asthma parasite infections some skin diseases lymphoma  (cancer associated with the immune system) Causes of monocytosis : infections from certain things like the  Epstein-Barr virus  (including  mononucleosis ),  tuberculosis , and fungus autoimmune diseases, like  lupus  and  ulcerative colitis having spleen removed Causes of basophilia: leukemia or bone marrow cancer (most often) occasionally allergic reactions (occasionally) Causes of lymphocytosis: viral infections whooping cough allergic reactions some kinds of leukemia

7. SIGNS AND SYMPTOMS Leukocytosis itself can cause symptoms. If the number of WNCs is high, it makes blood so thick that it can’t flow properly. This is a medical emergency that can cause: a stroke problems with vision breathing problems bleeding from areas covered with mucosa, such as mouth, stomach, and intestines This is called  hyperviscosity syndrome . It happens with leukemia, but it’s rare. Other symptoms of leukocytosis are related to the condition causing high number of WBCs, or sometimes due to effects of the specific type of white blood cell. These may include: fever and pain or other symptoms at the site of an infection fever, easy bruising, weight loss, and night sweats with leukemia and other cancers hives, itchy skin, and rashes from an allergic reaction on skin breathing problems and wheezing from an allergic reaction in lungs You may have no symptoms if leukocytosis is related to stress or a reaction to a drug.

8. DIAGNOSTIC EVAUATION Complete blood count (CBC) with differential.   This test  is almost always done when WBC count is higher than normal for unknown reasons. For this test, blood drawn from vein is run through a machine that identifies the percentage of each type of WBC. Knowing which types have higher than normal percentages can help doctor narrow down the possible causes of high WBC count. Peripheral blood smear.   This test  is done when neutrophilia or lymphocytosis is found because doctor can see if there are too many of the different types of leukocytes. For this test, a thin layer of blood sample is smeared on a slide. A microscope is then used to look at the cells. Bone marrow biopsy.   WBCs are made in bone marrow and then released into blood. When a high number of certain types of neutrophils are found on peripheral smear, doctor may perform  this test . Samples of bone marrow are removed from the center of a bone, usually hip, with a long needle and examined under a microscope. This test can tell doctor if there are abnormal cells or a problem with the production or release of cells from bone marrow.

9. MANAGEMENT Treatment of leukocytosis is based on what’s causing it: antibiotics for infection treatment of conditions that cause inflammation antihistamines and inhalers for allergic reactions chemotherapy, radiation, and sometimes a stem cell transplant for leukemia medication changes (if possible) if the cause is a drug reaction

10. PREVENTION maintaining a healthy lifestyle, including good handwashing to avoid an infection staying away from anything you know that might trigger an allergic reaction quitting smoking to avoid smoking-related leukocytosis, and lower risk of cancer taking medication as directed if you’re being treated for a condition that causes inflammation trying to lower the amount of stress in life, and getting treated for serious anxiety or emotional problems

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