LEUKOCYTOSIS (HIGH WHITE BLOOD CELLS): SYMPTOMS, CAUSES, TREATMENTS - MEDICINE - 2025

The leukocytosis occurs when the number of white blood cells exceeds normal levels. It is often the sign of an inflammatory response, most commonly the result of an infection. However, it can also occur after certain parasitic infections or bone tumors, or after strenuous exercise, seizures such as epilepsy, emotional stress, pregnancy and childbirth, anesthesia, and administration of epinephrine.

Leukocytosis, defined as a white blood cell count greater than 11,000 per mm3 (11 × 109 per L), 1 is frequently found in the course of routine laboratory tests. An elevated white blood cell count typically reflects the normal response of the bone marrow to an infectious or inflammatory process.

Less common but more serious causes include disorders of the primary bone marrow. The normal reaction of the bone marrow to infection or inflammation leads to an increase in the number of white blood cells, predominantly polymorphonuclear leukocytes and less mature cell forms (shift to the left).

A white blood cell count above 25 to 30 x 109 / L is called a leukemoid reaction, which is the reaction of a healthy bone marrow to extreme stress, trauma, or infection.

It is different from leukemia and leukoerythroblastosis, in which immature white blood cells (acute leukemia) or mature but non-functional white blood cells (chronic leukemia) are found in the peripheral blood.

Classification: types

Leukocytosis can be subclassified by the type of white blood cell that increases in numbers. There are five main types of leukocytosis: neutrophilia (the most common form), lymphocytosis, monocytosis, eosinophilia, and basophilia.

• Neutrophilia: it is the leukocytosis in which the neutrophils are elevated.
• Lymphocytosis: is the leukocytosis in which the lymphocyte count is high.
• Monocytosis: is the leukocytosis in which the monocyte count is high.
• Eosinophilia: is the leukocytosis in which the eosinophil count is elevated.
• Basophilia: is a condition in which the number of basophils is abnormally high.
• Leukostasis: An extreme form of leukocytosis, in which the white blood cell count exceeds 100,000 / μL, is leukostasis. In this form, there are so many white blood cells that groups of them block blood flow. This leads to ischemic problems including transient ischemic attack and stroke.

Causes

There can be several causes of leukocytosis:

-Acute infection: caused by certain agents that would trigger neutrophilia. Bacterial and viral infections are just a few of the common infections that cause neutrophilia. Yeast infections are also included in the list.

-Inflammation: there are non-infectious inflammations that would trigger an increase in neutrophils. These conditions that trigger inflammation are burns, postoperative, autoimmune conditions, and an acute attack of myocardial infarction, among other conditions that induce elevated levels of neutrophils.

-Metabolic processes: there are certain conditions that are out of the ordinary and cause neutrophilia, such as diabetic ketoacidosis, uremia and pre-eclampsia.

-Hemorrhage: sudden bleeding can facilitate the inflammatory process at work, thus inducing neutrophilia.

-Septicemia: this induces the bone marrow to release neutrophils in order to fight infection.

-Cigarette smoking: it can induce the elevation of neutrophils in the system due to the inflammation it causes.

-Stress: there will be an increase in neutrophils once stress attacks, as in cases where a person is anxious and has seizures.

-Drugs: taking certain drugs seems to raise the white blood cell count and these are corticosteroids.

-Malignancy: such as a carcinoma (cancer), sarcoma, etc.

Symptoms

Symptoms may include: infection - bleeding leading to hypotension, tachycardia, and most likely sepsis; hypothermia or a decrease in body temperature; tachypnea and dyspnea.

Treatment

-Reference to a hematologist: this is necessary to identify certain conditions, such as blood problems.

-Bone marrow aspiration: this will identify the presence of hematological problems. Bone marrow depression may be present, so the bone marrow aspiration sample is necessary.

-Close monitoring of blood results are necessary to check the progress of the condition. This is necessary for the success of the treatment course can be achieved.

-Maintaining a healthy lifestyle can avoid acquiring acute infections that are highly causative of neutrophilia. Having yearly flu shots can also prevent you from getting viral infections. Slowly reducing or stopping bad habits that can disrupt the body's natural defenses is a preventive measure for neutrophilia.

Causes and symptoms of lymphocytosis

Causes

Causes of non-neoplastic lymphocytosis include acute viral disease (CMV, EBV, HIV), chronic viral infections (hepatitis A, B, or C), chronic infections (tuberculosis, brucellosis, syphilis), protozoal infections (toxoplasmosis), and rarely bacterial infections (B. pertussis). Lymphocytosis can also be associated with drug reactions, connective tissue disorders, thyrotoxicosis, and Addison's disease.

Symptoms

Fever, sore throat, general malaise. Also atypical lymphocytes in the blood and lymphadenopathy are common symptoms of lymphocytosis.

Treatment

In order to cure lymphocytosis, people must first address the underlying health problem that has caused it to develop. Treating or curing the underlying causes of lymphocytosis can decrease the body's need to make more lymphocytes to protect it from disease or infection.

Causes, symptoms and treatment of monocytosis

Causes

Monocytes are formed in the bone marrow and play an important role in the normal functioning of the immune system. Inflammatory disorders, infection, and certain forms of cancer are the most common causes of monocytosis.

Some of the more common types of infection that could lead to this condition include tuberculosis, syphilis, and Rocky Mountain spotted fever.

Autoimmune disorders like lupus or rheumatoid arthritis can also lead to monocytosis. Similarly, some blood disorders can lead to large numbers of monocytes.

Symptoms

Symptoms usually include fatigue, weakness, fever, or a general feeling of being ill.

Treatment

Management of this condition involves diagnosing and treating the underlying cause of the elevated blood cell, and any questions or concerns about individual cases of monocytosis should be discussed with a physician or other medical professional.

The use of prescription medications - often including antibiotics or steroid medications - can sometimes return the blood count to normal, although the condition can become chronic in some patients.

Causes and symptoms of eosinophilia

Causes

• Allergy diseases: asthma, urticaria, eczema, allergic rhinitis, angioneurotic edema.
• Drug Hypersensitivity: Drugs that most commonly cause eosinophilia include anticonvulsants, allopurinol, sulfonamides, and certain antibiotics.
• Connective tissue diseases: vasculitis (Churg-Strauss syndrome); rheumatoid arthritis; eosinophilic fasciitis; polyarteritis nodosa; eosinophilia, myalgia syndrome.
• Infections: in particular, parasitic infections including ascariasis, schistosomiasis, tricinellosis, visceral larva migrans, strongyloidiasis, echinococcosis, and coccidioidomycosis.
• Hypereosinophilic syndromes (HES): it is a group of disorders that cause a high degree of persistent eosinophilia, where other causes have been excluded.
• Neoplasia:

  -Lymphoma (eg, Hodgkin's lymphoma, non-Hodgkin's lymphoma).

  -Leukemia: chronic myeloid leukemia, adult T-cell leukemia / lymphoma (ATLL), eosinophilic leukemia (very rare).

  -Gastric cancer or lung cancer (i.e. paraneoplastic eosinophilia).

• Endocrine: adrenal insufficiency - for example, Addison's disease.
• Skin disease - pemphigus, dermatitis herpetiformis, erythema multiforme.
• Löffler syndrome (accumulation of eosinophils in the lungs, due to parasitic infection.
• Löffler endocarditis (restrictive cardiomyopathy with eosinophilia).
• Irradiation.
• Post-splenectomy.
• Cholesterol embolism

Symptoms

The symptoms depend on the cause that produces them. For example, eosinophilia due to asthma is marked by symptoms such as wheezing and dyspnea, while parasitic infections can lead to abdominal pain, diarrhea, fever, or cough and rash.

Medicinal reactions usually lead to rashes, and this often occurs after taking a new drug. The rarer symptoms of eosinophilia can include weight loss, night sweats, enlarged lymph nodes, other skin rashes, numbness, and tingling due to nerve damage.

Hypereosinophilic syndrome is a condition in which there is no apparent cause of eosinophilia. This rare condition can affect the heart, resulting in heart failure with shortness of breath and swelling in the ankle, causing enlargement of the liver and spleen, leading to swelling of the abdomen, and skin rashes.

Treatment

Treatment addresses the underlying cause of the condition, whether it is an allergy, a drug reaction, or a parasitic infection. These treatments are generally effective, and non-toxic.

Treatment for hypereosinophilic syndrome is oral corticosteroid therapy, usually starting with prednisolone (eg, Deltacortril) in single daily doses of 30-60 mg. If this is not effective, a chemotherapeutic agent is administered.

Living with eosinophilia

In most cases, when the cause of eosinophilia is identified, treatment significantly reduces the symptoms of the disease. Corticosteroids, both local (inhaled, topical) and systemic (oral, intramuscular, intravenous), are used to control various allergic conditions and to reduce the number of eosinophils.

In hypereosinophilic syndrome, there is a high risk of damage to the heart and other important organs. In some cases a blood cell tumor known as T-cell lymphoma can also develop, so patients must be carefully monitored.

Causes and symptoms of basophilia

• Infections - Certain bacterial and viral infections, such as the flu, chickenpox, and tuberculosis.
• Allergy: the concentration of basophils increases in allergic conditions such as rhinitis and urticaria.
• Basophils reach high levels in the circulating blood in inflammatory conditions such as rheumatoid arthritis, chronic eczema, among others.
• People suffering from iron deficiency anemia have an increased activity of basophils in the circulating blood.
• Endocrine diseases such as elevated hypothyroidism and diabetes mellitus show basophil activity in the blood.

Symptoms

Symptoms will vary depending on the underlying cause of basophilia. For example, myeloproliferative neoplasms often cause an enlarged spleen, resulting in abdominal discomfort and a feeling of fullness.

On the other hand, the anemic condition is marked by weakness, persistent fatigue, and headache. While thyroid problems like hypothyroidism can cause constipation, muscle aches, unexplained weight gain, and stiff joints.

Treatment

Treatment of basophilia mainly depends on its cause:

• Anti-allergy medications will help reduce symptoms of allergic conditions, as well as levels in the blood.
• Often times, other bacterial infections require antibiotics to kill the pathogens.
• Increased basophils in the blood are not a cause for concern in problems such as hypothyroidism. Taking the proper medication for hypothyroidism will bring the basophil level back to normal.
• Taking supplemental iron treatment, under medical supervision.
• In severe cases, such as leukemia, a bone marrow transplant may be required.

When associated with allergies, infections, or thyroid problems, basophilia is not usually a concern, as it can be resolved by taking the appropriate medication. However, it is a serious condition when the condition arises from bone marrow cancer.

Acute leukemias

Patients with acute leukemia often have signs and symptoms of bone marrow failure, such as fatigue and paleness, fever, infection, and / or bleeding.

In acute leukemias, the marrow is often overcrowded with blast cells. These cells are indistinguishable from stem cells by light microscopy, but the term "burst" implies an acute leukemic clone.

The cellular elements of mature normal bone marrow are diminished or absent. Peripheral leukemic cell counts can range from leukocytosis to leukopenia, but anemia and thrombocytopenia are common.

Acute leukemias are broadly divided into two classes based on the cell of origin: acute lymphocytic leukemia and acute non-lymphocytic leukemia.

The designation "acute myeloid leukemia" has been replaced by "acute non-lymphocytic leukemia" to adequately encompass the full range of possible abnormal cells (undifferentiated, myeloid, monocytic, and megakaryocytic).

Acute lymphocytic leukemia most commonly occurs in children younger than 18 years of age. Adults often have acute non-lymphocytic leukemia. Occasionally, patients with acute lymphocytic leukemia have a mediastinal mass or central nervous system involvement early in the disease.

All patients with acute leukemia require immediate care and therapy. White blood cell counts greater than 100,000 per mm3 (100 × 109 per L) constitute a medical emergency because patients with this degree of leukocytosis are predisposed to stroke or hemorrhage.

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