Leukocytosis - Wikipedia https://en.wikipedia.

org/wiki/Leukocytosis

Leukocytosis
Leukocytosis is a condition in which the white cell (leukocyte count) is above
Leukocytosis
the normal range in the blood.[1][2] It is frequently a sign of an inflammatory
response,[3] most commonly the result of infection, but may also occur following Specialty Infectious disease,
certain parasitic infections or bone tumors as well as leukemia. It may also occur pathology
after strenuous exercise, convulsions such as epilepsy, emotional stress,
pregnancy and labor, anesthesia, as a side effect of medication (e.g. Lithium), and epinephrine administration.[1]

There are five principal types of leukocytosis:[4]

1. Neutrophilia (the most common form)[5]

2. Lymphocytosis
3. Monocytosis
4. Eosinophilia
5. Basophilia

This increase in leukocyte (primarily neutrophils) is usually accompanied by a "left upper shift" in the ratio of
immature to mature neutrophils and macrophages. The proportion of immature leukocytes increases due to
proliferation and inhibition of granulocyte and monocyte precursors in the bone marrow which is stimulated by
several products of inflammation including C3a and G-CSF. Although it may indicate illness, leukocytosis is
considered a laboratory finding instead of a separate disease. This classification is similar to that of fever, which is
also a test result instead of a disease. "Right shift" in the ratio of immature to mature neutrophils is considered
with reduced count or lack of "young neutrophils" (metamyelocytes, and band neutrophils) in blood smear,
associated with the presence of "giant neutrophils". This fact shows suppression of bone marrow activity, as a
hematological sign specific for pernicious anemia and radiation sickness.[6]

A leukocyte count above 25 to 30 x 109/L is termed a leukemoid reaction, which is the reaction of a healthy bone
marrow to extreme stress, trauma, or infection. It is different from leukemia and from leukoerythroblastosis, in
which either immature white blood cells (acute leukemia) or mature, yet non-functional, white blood cells (chronic
leukemia) are present in peripheral blood.

Contents
Classification
Causes
Diagnosis
Leukocyte counts
Treatment
See also
References
External links

Classification
Leukocytosis can be subcategorized by the type of white blood cell that is increased in number. Leukocytosis in which
neutrophils are elevated is neutrophilia; leukocytosis in which lymphocyte count is elevated is lymphocytosis;
leukocytosis in which monocyte count is elevated is monocytosis; and leukocytosis in which eosinophil count is

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elevated is eosinophilia.[7]

An extreme form of leukocytosis, in which the WBC count exceeds 100,000/µL, is leukostasis. In this form there are
so many WBCs that clumps of them block blood flow. This leads to ischemic problems including transient ischemic
attack and stroke.

Causes

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Causes of leukocytosis

Acute bacterial infections, especially pyogenic infections[7]

Sterile inflammation
Neutrophilic
leukocytosis Tissue necrosis[7]
(neutrophilia)
Myocardial infarction[7]
Burns[7]

Allergic disorders

Asthma[7]
Hay fever[7]
Drug allergies[7]
Allergic skin diseases[7]

Pemphigus[7]
Eosinophilic
leukocytosis Dermatitis herpetiformis
(eosinophilia) Parasitic infections[7]
Some forms of malignancy

Hodgkin's lymphoma[7]
Some forms of Non-Hodgkin lymphoma[7]
Systemic autoimmune diseases[7] (e.g. SLE)
Some forms of vasculitis[7]
Cholesterol embolism (transiently)[7]

(rare)[7]
Basophilic
leukocytosis Myeloproliferative disease, e.g. Chronic myelogenous leukemia[7]
Basophilia

Chronic infections[7]

Tuberculosis[7]
Bacterial endocarditis[7]
Monocytosis
Rickettsiosis[7]
Malaria[7]
Systemic autoimmune diseases, e.g. SLE[7]
Inflammatory bowel diseases, e.g. ulcerative colitis[7]

Chronic infections[7]

Tuberculosis[7]
Brucellosis[7]
Viral infections
Lymphocytosis
Hepatitis[7]
Cytomegalovirus infection[7]
Infectious mononucleosis[7]
Pertussis[7]
some forms of malignancy, such as lymphocytic leukæmias

Leukocytosis is very common in acutely ill patients. It occurs in response to a wide variety of conditions, including
viral, bacterial, fungal, or parasitic infection, cancer, hemorrhage, and exposure to certain medications or chemicals
including steroids.

For lung diseases such as pneumonia and tuberculosis, WBC count is very important for the diagnosis of the disease,

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as leukocytosis is usually present.

The mechanism that causes leukocytosis can be of several forms: an increased release of leukocytes from bone
marrow storage pools, decreased margination of leukocytes onto vessel walls, decreased extravasation of leukocytes
from the vessels into tissues, or an increase in number of precursor cells in the marrow.[8]

Certain medications, including corticosteroids, lithium and beta agonists, may cause leukocytosis.[9]

Leukocytosis is an expected finding in healthy women during the post-partum period and is not a cause for alarm
unless accompanied by clinical manifestations of infection.[10]

Diagnosis

Leukocyte counts

Below are blood reference ranges for various types leucocytes/WBCs.[11] The 97.5 percentile (right limits in intervals
in image, showing 95% prediction intervals) is a common limit for defining leukocytosis.

Treatment
While treatment is usually not necessary in the majority of cases, hyperleukocytosis (WBC count > 50 or 100 x
109/L), which can be seen in some leukemic patients, is treated to prevent leukostasis.[12][13]

See also
Bacterial infection
Complete blood count
Leukocytosis in head trauma
White blood cell

References
1. Rogers, Kara, ed. (2011), "Leukocytosis definition" (https://books.google.com/books?id=iObZwlOu1mMC&pg=PA
198&dq=leukocytosis+abnormally+leukocytes&hl=en&ei=6cK-TsHlE6qemQWn4NW2BA&sa=X&oi=book_result&
ct=result&resnum=2&sqi=2&ved=0CDQQ6AEwAQ#v=onepage&q=leukocytosis%20abnormally%20leukocytes&f
=false), Blood: Physiology and Circulation (https://books.google.com/books?id=iObZwlOu1mMC&printsec=frontc
over&dq=blood+physiology+circulation#v=onepage&q&f=false), Chicago: Britannica Educational Publishing,
p. 198, ISBN 978-1-61530-250-5, retrieved 12 November 2011
2. TheFreeDictionary > Leukocytosis (http://medical-dictionary.thefreedictionary.com/leukocytosis) Citing: Gale
Encyclopedia of Medicine, 2008 and The American Heritage Medical Dictionary, 2007

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Leukocytosis - Wikipedia https://en.wikipedia.org/wiki/Leukocytosis

3. Porth, Carol Mattson (2011), "White blood cell response" (https://books.google.com/books?id=FFg88IaReBwC&p

g=PA64&dq=porth+leukocytosis+%22inflammatory+response%22&hl=en&ei=pxu_Tr75Fa-ziQfPytnSCg&sa=X&o
i=book_result&ct=result&resnum=2&ved=0CDcQ6AEwAQ#v=onepage&q&f=false), Essentials of
Pathophysiology: Concepts of Altered Health States (https://books.google.com/books?id=FFg88IaReBwC&prints
ec=frontcover&dq=%22essentials+of+pathophysiology%22#v=onepage&q&f=false) (3rd ed.), Philadelphia:
Wolters Klower Health/Lippincott Williams & Wilkins, pp. 64–65, ISBN 978-1-58255-724-3, retrieved
13 November 2011
4. Zorc, Joseph J, ed. (2009), "Leukocytosis" (https://books.google.com/books?id=WM4K-T3fPC8C&pg=PA559&dq
=leukocytosis+neutrophilia+eosinophilia+basophilia+monocytosis+lymphocytosis&hl=en&ei=J86-TrmfHKKXiQeB
noWhBQ&sa=X&oi=book_result&ct=result&resnum=1&ved=0CC4Q6AEwADgK#v=onepage&q=leukocytosis%20
neutrophilia%20eosinophilia%20basophilia%20monocytosis%20lymphocytosis&f=false), Schwartz's Clinical
Handbook of Pediatrics (https://books.google.com/books?id=WM4K-T3fPC8C&printsec=frontcover&dq=schwartz'
s+pediatrics#v=onepage&q&f=false) (4th ed.), Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins, p. 559,
ISBN 978-0-7817-7013-2, retrieved 12 November 2011
5. Schwartz, M. William, ed. (2003), "Leukocytosis" (https://books.google.com/books?id=SRi0WnNisW8C&pg=PA54
&dq=leukocytosis+neutrophilia+eosinophilia+basophilia+monocytosis+lymphocytosis&hl=en&ei=J86-TrmfHKKXi
QeBnoWhBQ&sa=X&oi=book_result&ct=result&resnum=8&ved=0CFYQ6AEwBzgK#v=onepage&q=leukocytosi
s%20neutrophilia%20eosinophilia%20basophilia%20monocytosis%20lymphocytosis&f=false), The 5-Minute
Pediatric Consult (https://books.google.com/books?id=SRi0WnNisW8C&printsec=frontcover&dq=five+pediatric#v
=onepage&q&f=false) (3rd ed.), Philadelphia: Lippincott Williams & Wilkins, p. 54, ISBN 0-7817-3539-4, retrieved
12 November 2011
6. Lutan, Vasile. Fiziopatologie medicală. Vol. 2, 31.3.2.1. Leucocitozele; "Archived copy" (https://web.archive.org/w
eb/20120327020925/http://library.usmf.md/ebooks.php?key=b11). Archived from the original (http://library.usmf.m
d/ebooks.php?key=b11) on 2012-03-27. Retrieved 2011-09-25.
7. Table 12-6 in: Mitchell, Richard Sheppard; Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson, Robbins Basic
Pathology, Philadelphia: Saunders, ISBN 1-4160-2973-7 8th edition.
8. Riley LK and Rupert J. Evaluation of Patients with Leukocytosis. (http://www.aafp.org/afp/2015/1201/p1004.html)
2015 Dec. Am Fam Physician. 1;92(11):1004-11.
9. Leukocytosis: Basics of Clinical Assessment (http://www.aafp.org/afp/20001101/2053.html), American Family
Physician. November 2000.
10. Arbib, Nissim; Aviram, Amir; Gabbay Ben-Ziv, Rinat; Sneh, Orly; Yogev, Yariv; Hadar, Eran (2015-11-23). "The
effect of labor and delivery on white blood cell count" (http://www.tandfonline.com/doi/full/10.3109/14767058.201
5.1110572). The Journal of Maternal-Fetal & Neonatal Medicine: 1–5. doi:10.3109/14767058.2015.1110572 (http
s://doi.org/10.3109%2F14767058.2015.1110572). ISSN 1476-7058 (https://www.worldcat.org/issn/1476-7058).
11. Specific references are found in article Reference ranges for blood tests#White blood cells 2.
12. "Leukocytosis Treatment & Management" (https://emedicine.medscape.com/article/956278-treatment#d9).
Medscape.
13. Schiffer, Charles. "Hyperleukocytosis and leukostasis in hematologic malignancies" (https://www.uptodate.com/co
ntents/hyperleukocytosis-and-leukostasis-in-hematologic-malignancies#H16). UpToDate.

External links
Classification ICD-10: D72.8 (htt D
ps://icd.who.int/bro
wse10/2019/en#/D7
2.8) · ICD-9-CM:
288.3 (http://www.ic
d9data.com/getICD
9Code.ashx?icd9=2
88.3), 288.6x (http://
www.icd9data.com/
getICD9Code.ashx?
icd9=288.6x) ·
MeSH: D007964 (ht

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tps://www.nlm.nih.g
ov/cgi/mesh/2015/M
B_cgi?field=uid&ter
m=D007964) ·
DiseasesDB:
33024 (http://www.di
seasesdatabase.co
m/ddb33024.htm)

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