Leukocytosis: Basics of Clinical Assessment (2022)

Leukocytosis: Basics of Clinical Assessment (1)

NEIL ABRAMSON, M.D., AND BECKY MELTON, M.D.

Am Fam Physician. 2000;62(9):2053-2060

A more recent article on leukocytosis is available.

Leukocytosis, a common laboratory finding, is most often due to relatively benign conditions (infections or inflammatory processes). Much less common but more serious causes include primary bone marrow disorders. The normal reaction of 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 (the “left shift”). Physical stress (e.g., from seizures, anesthesia or overexertion) and emotional stress can also elevate white blood cell counts. Medications commonly associated with leukocytosis include corticosteroids, lithium and beta agonists. Increased eosinophil or basophil counts, resulting from a variety of infections, allergic reactions and other causes, can lead to leukocytosis in some patients. Primary bone marrow disorders should be suspected in patients who present with extremely elevated white blood cell counts or concurrent abnormalities in red blood cell or platelet counts. Weight loss, bleeding or bruising, liver, spleen or lymph node enlargement, and immunosuppression also increase suspicion for a marrow disorder. The most common bone marrow disorders can be grouped into acute leukemias, chronic leukemias and myeloproliferative disorders. Patients with an acute leukemia are more likely to be ill at presentation, whereas those with a chronic leukemia are often diagnosed incidentally because of abnormal blood cell counts. White blood cell counts above 100,000 per mm3 (100 × 109 per L) represent a medical emergency because of the risk of brain infarction and hemorrhage.

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 testing. An elevated white blood cell count typically reflects the normal response of bone marrow to an infectious or inflammatory process. Occasionally, leukocytosis is the sign of a primary bone marrow abnormality in white blood cell production, maturation or death (apoptosis) related to a leukemia or myeloproliferative disorder. Often, the family physician can identify the cause of an elevated white blood cell count based on the findings of the history and physical examination coupled with basic data from the complete blood count.

Production, Maturation and Survival of Leukocytes

Common progenitor cells, referred to as “stem cells,” are located in the bone marrow and give rise to erythroblasts, myeloblasts and megakaryoblasts. Three quarters of the nucleated cells in the bone marrow are committed to the production of leukocytes. These stem cells proliferate and differentiate into granulocytes (neutrophils, eosinophils and basophils), monocytes and lymphocytes, which together comprise the absolute white blood cell count. Approximately 1.6 billion granulocytes per kg of body weight are produced each day, and 50 to 75 percent of these cells are neutrophils.2 An abnormal elevation in the neutrophil count (neutrophilia) occurs much more commonly than an increase in eosinophils or basophils.

The maturation of white blood cells in the bone marrow and their release into the circulation are influenced by colony-stimulating factors, interleukins, tumor necrosis factor and complement components.3 Approximately 90 percent of white blood cells remain in storage in the bone marrow, 2 to 3 percent are circulating and 7 to 8 percent are located in tissue compartments.

The cells within the bone marrow compartment are classified into two populations: those that are in the process of DNA synthesis and maturation and those that are in a storage phase awaiting release into the circulating pool. The storage of maturing cells allows for rapid response to the demand for increased white blood cells, with a two- to threefold increase in circulating leukocytes possible in just four to five hours.

The circulating pool of neutrophils is divided into two classes. One pool of cells is circulating freely, and the second pool is deposited along the margins of blood vessel walls. When stimulated by infection, inflammation, drugs or metabolic toxins, the deposited cells “demarginate” and enter the freely circulating pool.

Once a leukocyte is released into circulation and tissue, it remains there only a few hours, at which time cell death occurs. The estimated life span of a white blood cell is 11 to 16 days, with bone marrow maturation and storage comprising the majority of the cell's life.

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Etiology of Leukocytosis

The investigation of leukocytosis begins with an understanding of its two basic causes: (1) the appropriate response of normal bone marrow to external stimuli and (2) the effect of a primary bone marrow disorder. Physiologic mechanisms of leukocytosis are listed in Table 1.

Normally responding bone marrow
Infection
Inflammation: tissue necrosis, infarction, burns, arthritis
Stress: overexertion, seizures, anxiety, anesthesia
Drugs: corticosteroids, lithium, beta agonists
Trauma: splenectomy
Hemolytic anemia
Leukemoid malignancy
Abnormal bone marrow
Acute leukemias
Chronic leukemias
Myeloproliferative disorders

Leukocytosis with Normal Bone Marrow

In most instances, increased white blood cell counts are the result of normal bone marrow reacting to inflammation or infection. Most of these cells are polymorphonuclear leukocytes (PML). Circulating PML and less mature forms (e.g., band cells and metamyelocytes) move to a site of injury or infection. This is followed by the release of stored leukocytes, commonly referred to as a “left shift.” Inflammation-associated leukocytosis occurs in tissue necrosis, infarction, burns and arthritis.

Leukocytosis may also occur as a result of physical and emotional stress.4,5 This is a transient process that is not related to marrow production or the release of band cells or other immature cells. Causes of stress leukocytosis include overexertion, seizures, anxiety, anesthesia and epinephrine administration. Stress leukocytosis reverses within hours of elimination of the inciting factor.

Other causes of leukocytosis include medications, splenectomy, hemolytic anemia and malignancy. Medications commonly associated with leukocytosis include corticosteroids, lithium and beta agonists.1,6,7 Splenectomy causes a transient leukocytosis that lasts for weeks to months. In hemolytic anemia, non-specific increases in leukocyte production and release occur in association with increased red blood cell production; marrow growth factors are likely contributors. Malignancy is another recognized cause of leukocytosis (and, occasionally, thrombocytosis); the tumor non-specifically stimulates the marrow to produce leukocytosis.

An excessive white blood cell response (i.e., more than 50,000 white blood cells per cm3 [50 × 109 per L]) associated with a cause outside the bone marrow is termed a “leukemoid reaction.” Even this exaggerated white blood cell count is usually caused by relatively benign processes (i.e., infection or inflammation). An underlying malignancy is the most serious but least common cause of a leukemoid reaction.

As mentioned previously, an increase in neutrophils is the most common cause of an elevated white blood cell count, but other sub-populations of cells (eosinophils, basophils, lymphocytes and monocytes) can also give rise to increased leukocyte numbers.

EOSINOPHILIA

Eosinophils are white blood cells that participate in immunologic and allergic events. Common causes of eosinophilia are listed in Table 2. The relative frequency of each cause usually relates to the clinical setting. For example, parasitic infections are often responsible for eosinophilia in pediatric patients, and drug reactions commonly cause an increased eosinophil count in hospitalized patients. Dermatologists frequently find eosinophilia in patients with skin rashes, and pulmonologists often see elevated numbers of eosinophils in conjunction with pulmonary infiltrates and bronchoallergic reactions.

Allergic events
Parasitic infections
Dermatologic conditions
Infections: scarlet fever, chorea, leprosy, genitourinary infections
Immunologic disorders: rheumatoid arthritis, periarteritis, lupus erythematosus, eosinophilia-myalgia syndrome
Pleural and pulmonary conditions: Löffler's syndrome, pulmonary infiltrates and eosinophilia
Malignancies: non-Hodgkin's lymphoma, Hodgkin's disease
Myeloproliferative disorders: chronic myelogenous leukemia, polycythemia vera, myelofibrosis
Adrenal insufficiency: Addison's disease
Sarcoidosis
(Video) Leukocytosis, Causes, Signs and Symptoms, Diagnosis and Treatment.

Other causes of eosinophilia include malignancies, especially those affecting the immune system (Hodgkin's disease and non-Hodgkin's lymphoma),8 and immunologic disorders such as rheumatoid arthritis and periarteritis. Eosinophilia-myalgia syndrome, a recently described disorder associated with dietary supplements of tryptophan, resembles a connective tissue disease with fibrosis of muscle fascial tissue and peripheral eosinophilia.9

BASOPHILIA

Basophilia is an uncommon cause of leukocytosis. Basophils are inflammatory mediators of substances such as histamine. These cells, along with similar tissue-based cells (mast cells), have receptors for IgE and participate in the degranulation of white blood cells that occurs during allergic reactions, including anaphylaxis.10 Causes of basophilia, some of uncertain origin, are listed in Table 3.

Infections: viral infections (varicella), chronic sinusitis
Inflammatory conditions: inflammatory bowel disease, chronic airway inflammation, chronic dermatitis
Myeloproliferative disorders: chronic myelogenous leukemia, polycythemia vera, myelofibrosis
Alteration of marrow and reticuloendothelial compartments: chronic hemolytic anemia, Hodgkin's disease, splenectomy
Endocrinologic causes: hypothyroidism, ovulation, estrogens

LYMPHOCYTOSIS

Lymphocytes normally represent 20 to 40 percent of circulating white blood cells. Hence, the occurrence of lymphocytosis often translates into an increase in the overall white blood cell count. Increased numbers of lymphocytes occur with certain acute and chronic infections (Table 4). Malignancies of the lymphoid system may also cause lymphocytosis.

Absolute lymphocytosis
Acute infections: cytomegalovirus infection, Epstein-Barr virus infection, pertussis, hepatitis, toxoplasmosis
Chronic infections: tuberculosis, brucellosis
Lymphoid malignancies: chronic lymphocytic leukemia
Relative lymphocytosis
Normal in children less than 2 years of age
Acute phase of several viral illnesses
Connective tissue diseases
Thyrotoxicosis
Addison's disease
Splenomegaly with splenic sequestration

Relative, rather than absolute, leukocytosis occurs in a number of clinical situations, such as infancy, viral infections, connective tissue diseases, thyrotoxicosis and Addison's disease. Splenomegaly causes relative lymphocytosis as a result of splenic sequestration of granulocytes.

Leukocytosis with Primary Bone Marrow Disorders

Clinical factors that increase suspicion of an underlying bone marrow disorder are listed in Table 5. Bone marrow disorders are generally grouped into leukemias and myeloproliferative disorders.

Leukocytosis: white blood cell count greater than 30,000 per mm3 (30 × 109 per L)*
Concurrent anemia or thrombocytopenia
Organ enlargement: liver, spleen or lymph nodes
Life-threatening infection or immunosuppression
Bleeding, bruising or petechiae
Lethargy or significant weight loss

Marrow abnormalities may occur with stem cells (acute leukemia) or more differentiated cells (chronic leukemia). Delineating acute leukemias from chronic leukemias is clinically important because the acute forms are more often associated with rapidly life-threatening complications such as bleeding, brain infarction and infection. Differences in the clinical presentations of acute and chronic leukemias are provided in Table 6.

(Video) Neutrophilia & Leukocytosis - Pathophysiology of Leukocytosis, Causes & Evaluation

Patient group and type of leukemiaSymptomsSignsLaboratory findings
Children: acute lymphocytic leukemiaInfection, bleeding, weaknessEnlarged liver, spleen or lymph nodesVariable white blood cell count, anemia, thrombocytopenia, blast cells
Adults: acute nonlymphocytic leukemia (acute myeloid leukemia)
Adults: chronic myelogenous leukemiaNone, or malaise and abdominal discomfortEnlarged spleenLeukocytosis (myeloid precursors), normal or increased platelet count
Older adults: chronic lymphocytic leukemiaNone, or nonspecific symptomsEnlarged spleen or lymph nodesLeukocytosis (lymphocytes)

ACUTE LEUKEMIAS

Patients with an acute leukemia often present with signs and symptoms of bone marrow failure, such as fatigue and pallor, fever, infection and/or bleeding with purpura and petechiae. In acute leukemias, the marrow is typically overpopulated with blast cells. These cells are indistinguishable from stem cells by light microscopy, but the term “blast” implies an acute leukemic clone. The maturing normal marrow cellular elements are decreased or absent. Peripheral leukemic cell counts may range from leukocytosis to leukopenia, but, as anticipated, anemia and thrombocytopenia are common.

The acute leukemias are broadly divided into two classes based on the cell of origin: acute lymphocytic leukemia and acute non-lymphocytic leukemia. The previous designation of “acute myeloid leukemia” has been replaced by “acute nonlymphocytic leukemia” to appropriately encompass the full variety of possible abnormal cells (undifferentiated, myeloid, monocytic and megakaryocytic).

Acute lymphocytic leukemia most commonly occurs in children less than 18 years of age. Adults usually have acute nonlymphocytic leukemia. Occasionally, patients with acute lymphocytic leukemia have a mediastinal mass or central nervous system involvement at the onset of illness.

Blast cells are often seen in the peripheral blood smears of patients with acute leukemia. Auer rods, as shown in Figure 1, are a marker of acute nonlymphocytic leukemia. Because Auer rods do not appear frequently, precise distinction between acute lymphocytic leukemia and acute nonlymphocytic leukemia usually cannot be accomplished based on the peripheral smear alone; histochemistry, immunotyping and chromosome analysis are usually required.

Leukocytosis: Basics of Clinical Assessment (2)

All patients with acute leukemia require prompt attention and therapy. White blood cell counts in excess of 100,000 per mm3 (100 × 109 per L) constitute a medical emergency because patients with this degree of leukocytosis are predisposed to brain infarction or hemorrhage.

CHRONIC LEUKEMIAS

Patients with a chronic leukemia typically present with much less severe illness than those with an acute leukemia. Chronic leukemia is usually diagnosed incidentally based on high white blood cell counts. The chronic leukemias are divided into two groups according to the cell of origin: chronic lymphocytic leukemia and chronic myelogenous leukemia.

Chronic lymphocytic leukemia results from the proliferation and persistence (lack of apoptosis) of relatively mature-appearing lymphocytes (Figure 2). The spleen and lymph nodes are enlarged because of the excessive accumulation of lymphocytes. Despite the increased number of lymphocytes, this disease is associated with impaired immunity as a result of the scarcity of normal lymphocytes.

Leukocytosis: Basics of Clinical Assessment (3)

Unless complications are present, patients with chronic lymphocytic leukemia do not require urgent referral to a hematologist. In the absence of symptoms, such as fever, sweats, weight loss, anemia, moderate thrombocytopenia or organ enlargement, the leukocytosis usually does not require treatment.

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Chronic myelogenous leukemia, which affects myeloid cells (polymorphonuclear cells and less mature cell forms), is frequently diagnosed after the incidental finding of a high white blood cell count. A peripheral blood smear from a patient with this form of leukemia is shown in Figure 3. In some situations, the smear can also show increases in basophils or eosinophils.

Leukocytosis: Basics of Clinical Assessment (4)

Middle-aged adults more commonly develop chronic myelogenous leukemia. Some patients describe fatigue, bleeding or weight loss. Splenomegaly is frequently present, and the markedly enlarged spleen sometimes causes abdominal discomfort, indigestion or early satiety. Lymphadenopathy is uncommon.

Platelet counts are usually normal to increased. In fact, chronic myelogenous leukemia is the only leukemic process that is associated with thrombocytosis. Another laboratory feature that distinguishes this disease from other leukemias and myeloproliferative disorders is the presence of the Philadelphia chromosome, an abnormality of translocation between chromosome 22 and chromosome 9.

Chronic myelogenous leukemia eventually develops an accelerated phase and subsequently transforms into acute leukemia. The accelerated phase is characterized by fever, sweats, weight loss, bone pain, bruising and hepatosplenomegaly. During this time, thrombocytopenia and anemia develop. The median time for transformation of chronic myelogenous leukemia to acute leukemia is two to five years. After the development of acute leukemia, median survival is short.

MYELOPROLIFERATIVE DISORDERS

The myeloproliferative disorders include chronic myelogenous leukemia, polycythemia vera, myelofibrosis and essential thrombocythemia (Table 7). Because all of these entities may present with leukocytosis, differentiation can be difficult and usually requires special laboratory studies and bone marrow examinations.11

DiseaseRed blood cellsWhite blood cellsPlateletsMarrow
Polycythemia veraIncreasedNormal or increasedNormal or increasedHypercellular
Chronic myelogenous leukemiaNormal or increasedIncreasedNormal or increasedHypercellular
MyelofibrosisNormal or decreasedVariableVariableFibrosis
Essential thrombocythemiaNormal or decreasedSlightly increased or normalIncreasedHypercellular

Polycythemia vera usually presents with excessive numbers of erythroid cells, but increased white blood cell and platelet counts may also be evident. Symptoms resulting from hypervolemia and hyperviscosity, such as headache, dizziness, visual disturbances and paresthesias, are sometimes present. Less frequently, patients with polycythemia vera develop myocardial infarction, stroke, venous thrombosis and congestive heart failure. Overall survival is long (10 to 20 years).

Myelofibrosis is a bone marrow disorder in which fibroblasts replace normal elements of the marrow. Patients with myelofibrosis are usually 50 years or older and have a median survival of less than 10 years. As bone marrow fibrosis develops, patients can present with leukocytosis, although decreased white blood cell, red blood cell and platelet counts are more common. Patients are asymptomatic early in the course of the disease and are usually diagnosed incidentally based on changes in blood cell counts. Symptomatic patients have fatigue, shortness of breath, weight loss, bleeding or abdominal discomfort related to splenomegaly. Acute leukemia can develop over time and, when it occurs, progresses rapidly.

Leukocytosis is also found in patients with essential thrombocythemia (primary thrombocythemia). Although elevated platelet counts occur in all myeloproliferative disorders, essential thrombocythemia is distinguished by the singular prominence of platelets. Markers of other disorders, such as the Philadelphia chromosome and bone marrow fibrosis, are absent. It is important to exclude secondary thrombocytosis caused by nonmarrow disorders (e.g., iron deficiency or bleeding). Most patients with essential thrombocythemia are asymptomatic and require little, if any, therapy, although some patients develop thrombosis or hemorrhage secondary to increased numbers of dysfunctional platelets.

Final Comment

Excessive numbers of white blood cells are most often due to the response of normal bone marrow to infection or inflammation. In some instances, leukocytosis is a sign of more serious primary bone marrow disease (leukemias or myeloproliferative disorders). Attention to clinical factors associated with marrow disorders, such as extremely elevated white blood cell counts, abnormalities in red blood cell or platelet counts, weight loss, bleeding and organ enlargement, can help the family physician decide which patients require further investigation and consultation.

(Video) Leukocytosis and types . Medical Education Podcast

FAQs

What does it mean if you have leukocytosis? ›

Leukocytosis means you have a high white blood cell count. This means you have more white blood cells than normal. Leukocytosis is a normal immune response and isn't always a cause for concern. Most of the time, it means that your body is fighting off infection or inflammation.

What is the cause of leukocytosis under conditions of stress? ›

Leukocytosis may also occur as a result of physical and emotional stress. This is a transient process that is not related to marrow production or the release of band cells or other immature cells. Causes of stress leukocytosis include overexertion, seizures, anxiety, anesthesia and epinephrine administration.

How does leukocytosis affect the body? ›

When you have very high levels of white blood cells in your body, they can cause your blood to become very thick, which can impair blood flow. This can lead to a condition called hyperviscosity syndrome.

What is the clinical importance of doing a leukocyte count? ›

A white blood count is most often used to help diagnose disorders related to having a high white blood cell count or low white blood cell count. Disorders related to having a high white blood count include: Autoimmune and inflammatory diseases, conditions that cause the immune system to attack healthy tissues.

What is the range for leukocytosis? ›

The normal white blood cell (WBC) counts in peripheral blood is within a reference range from 4,300 to 10,800 WBC/mm3. Leukocytosis is usually defined as a white blood cell count greater than 11,000/mm3 (11×109/l). Two important pathophysiological mechanisms are involved in the etiology of leukocytosis.

Can leukocytosis lead to leukemia? ›

Leukocytosis is often the initial finding that leads to the diagnosis of a primary hemato- logic disorder, such as leukemia or a myeloproliferative neoplasm.

What medications cause leukocytosis? ›

Among the most common medications causing leukocytosis are corticosteroids, lithium, and β-agonists. Also implicated are recombinant cytokines, antihypertensives, antifungals, antibiotics, anticonvulsants, antidiabetics, antidepressants, and others.

Is leukocytosis a symptom? ›

Leukocytosis may be a temporary response to an infection or injury as the body is healing naturally, or it can be a sign of disease. It may develop as a side effect of some medications, or it may reflect an underlying autoimmune disease. Leukocytosis can involve all types of white blood cells or just a few.

What causes leukocytosis without infection? ›

Stressors capable of causing an acute leukocytosis include surgery, exercise, trauma, and emotional stress. Other nonmalignant etiologies of leukocytosis include certain medications, asplenia, smoking, obesity, and chronic inflammatory conditions.

How long does leukocytosis last? ›

Leukocytosis reached maximal values within two weeks in most cases, after which the white blood cell count decreased, albeit not to pretreatment levels.

How do you control leukocytes? ›

White blood cells or leukocytes help fight infections.
...
To lower your high white blood cell count, you should include the following in your diet:
  1. Vitamin C. ...
  2. Antioxidants. ...
  3. Omega-3 Fatty Acids. ...
  4. Avoid foods rich in sugar, fat and salt.

Can stress cause high white blood cell count? ›

Stress—Finally, emotional or physical stress can also cause elevated white blood cell counts. The good news is that white blood cell levels will return to normal after the stress is gone.

What are the symptoms of high white blood cell count? ›

Symptoms of a High White Blood Cell Count
  • Fever.
  • Fatigue.
  • Decreased appetite.
  • Sweats.
  • Chills.
  • Swelling of an area of infection.
  • Joint swelling due to infection or autoimmune disease.
  • Itching, with or without a rash.
31 Mar 2022

What are the 5 types of white blood cells and their functions? ›

Types of white blood cells
  • Monocytes. They have a longer lifespan than many white blood cells and help to break down bacteria.
  • Lymphocytes. They create antibodies to fight against bacteria, viruses, and other potentially harmful invaders.
  • Neutrophils. They kill and digest bacteria and fungi. ...
  • Basophils. ...
  • Eosinophils.

Is leukocytosis a bacterial infection? ›

Causes. 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.

Can leukocytosis cause death? ›

Neutrophilic Leukocytosis

It can cause a stroke or breathing problems that could lead to death. Doctors treat this syndrome by adding fluid to the blood and using drugs to reduce the neutrophils in the blood.

What does it mean to be positive for leukocytes? ›

Leukocyte esterase is a screening test used to detect a substance that suggests there are white blood cells in the urine. This may mean you have a urinary tract infection. If this test is positive, the urine should be examined under a microscope for white blood cells and other signs that point to an infection.

Can leukocytosis cause stroke? ›

Leukocytosis is a common finding in the acute phase of stroke. A detrimental effect of leukocytosis on stroke outcome has been suggested, and trials aiming at reducing the leukocyte response in acute stroke are currently being conducted. However, the influence of leukocytosis on stroke outcome has not been clarified.

Can dehydration cause leukocytosis? ›

Leukocytosis (WBC > 10,000/mm 3) can indicate infection, inflammation (possibly from allergies), tissue damage or burns, dehydration, thyroid storm, leukemia, stress, or steroid use. The degree of leukocytosis depends on the severity of the disorder, the patient's age and general health, and bone marrow health.

Can you have surgery with high white blood cell count? ›

Answer: Abnormally high white blood cell count

Hopefully, your WBC count has returned to normal and you can proceed with surgery. Surgery will cause it to temporarily rise and fall once again. Following the WBC count is a good way to know that your immune system is working properly.

Does Covid increase white blood count? ›

Significantly higher and gradually increasing median WBC count values were observed after five days of hospital admission.

What is a normal white blood cell count for a woman? ›

Normal white blood cell count

For women, it is a reading of between 4,500 and 11,000 per μl, and for children between 5,000 and 10,000.

What treatment if white blood cells are high? ›

Leukapheresis is a way of removing abnormal white blood cells from the blood. You might have this treatment if you have a very high white blood cell count. Very high numbers of leukaemia cells in the blood can cause problems with normal circulation.

Which medicine is best for high WBC? ›

Hydroxyurea (Hydrea®) is sometimes given to lower very high WBC counts rapidly until a CML diagnosis is confirmed through blood and bone marrow tests. Hydroxyurea is taken as a capsule by mouth. Lowering those very high WBC counts can help reduce the size of the spleen.

What foods decrease white blood cells? ›

If you have neutropenia, you should avoid raw meat, eggs and fish, moldy or expired food, unwashed or moldy fruit and vegetables, and unpasteurized beverages, including fruit and vegetable juice, beer, milk, as well as unpasteurized honey.

Can lack of sleep cause high white blood cell count? ›

Sleep restriction to four hours of sleep during three consecutive nights induced an increase in WBC counts, mainly neutrophils in young healthy subjects. The stress induced by the sleep restriction could be one mechanism involved.

What level of WBC is alarming? ›

The exact threshold for a high white blood cell count varies from one laboratory to another. In general, for adults a count of more than 11,000 white blood cells (leukocytes) in a microliter of blood is considered a high white blood cell count.

How long does it take for WBC to return to normal? ›

Based on the nature of the infection, it takes the body up to 5 to 25 days for the white blood cell count to return to normal.

What are the two main types of leukocytes? ›

Granulocytes and agranulocytes are the two types of white blood cells or leukocytes.

Which are characteristic of leukocytes? ›

A white blood cell, also known as a leukocyte or white corpuscle, is a cellular component of the blood that lacks hemoglobin, has a nucleus, is capable of motility, and defends the body against infection and disease.

What are the two types of white blood cells? ›

Types of white blood cells are granulocytes (neutrophils, eosinophils, and basophils), monocytes, and lymphocytes (T cells and B cells).

What causes high white blood cell count in elderly? ›

In the elderly, total WBC will decrease slightly. In response to acute infection, trauma or inflammation, the number of WBCs increases and in some diseases, such as sepsis, the increase in WBC is so dramatic that resembles leukemia (leukemoid reaction).

How long do antibiotics affect white blood cell count? ›

An initial decrease in leukocyte count was seen 2.5 hours after dosing was completed, though levels returned to normal 24 hours after dosing was completed.

What is the role of leukocytes? ›

Leukocytes are part of the body's immune system. They help the body fight infection and other diseases. Types of leukocytes are granulocytes (neutrophils, eosinophils, and basophils), monocytes, and lymphocytes (T cells and B cells).

What is the other name of WBC? ›

White blood cells, also known as leukocytes, are responsible for protecting your body from infection. As part of your immune system, white blood cells circulate in your blood and respond to injury or illness.

What are the 7 types of blood cells? ›

Blood contains many types of cells: white blood cells (monocytes, lymphocytes, neutrophils, eosinophils, basophils, and macrophages), red blood cells (erythrocytes), and platelets. Blood circulates through the body in the arteries and veins.

What causes leukocytosis without infection? ›

Stressors capable of causing an acute leukocytosis include surgery, exercise, trauma, and emotional stress. Other nonmalignant etiologies of leukocytosis include certain medications, asplenia, smoking, obesity, and chronic inflammatory conditions.

What is an alarming WBC count? ›

In general, for adults a count of more than 11,000 white blood cells (leukocytes) in a microliter of blood is considered a high white blood cell count.

Is leukocytosis a symptom? ›

Leukocytosis may be a temporary response to an infection or injury as the body is healing naturally, or it can be a sign of disease. It may develop as a side effect of some medications, or it may reflect an underlying autoimmune disease. Leukocytosis can involve all types of white blood cells or just a few.

What drugs cause leukocytosis? ›

Among the most common medications causing leukocytosis are corticosteroids, lithium, and β-agonists. Also implicated are recombinant cytokines, antihypertensives, antifungals, antibiotics, anticonvulsants, antidiabetics, antidepressants, and others.

How long does leukocytosis last? ›

Leukocytosis reached maximal values within two weeks in most cases, after which the white blood cell count decreased, albeit not to pretreatment levels.

What does it mean to be positive for leukocytes? ›

Leukocyte esterase is a screening test used to detect a substance that suggests there are white blood cells in the urine. This may mean you have a urinary tract infection. If this test is positive, the urine should be examined under a microscope for white blood cells and other signs that point to an infection.

Can stress cause high white blood cell count? ›

Stress—Finally, emotional or physical stress can also cause elevated white blood cell counts. The good news is that white blood cell levels will return to normal after the stress is gone.

Can leukocytosis be fatal? ›

Acute or chronic significant leukocytosis above 25x10^9/mL, however, can have severe complications and potentially be fatal.

Which food reduce WBC count? ›

To lower your high white blood cell count, you should include the following in your diet: Vitamin C. Eating Vitamin C will help regulate the levels of white blood cells in your body. Fruits like lemons, oranges, and lime are rich in vitamin C, and so are papayas, berries, guavas, and pineapples.

Can dehydration cause leukocytosis? ›

Leukocytosis (WBC > 10,000/mm 3) can indicate infection, inflammation (possibly from allergies), tissue damage or burns, dehydration, thyroid storm, leukemia, stress, or steroid use. The degree of leukocytosis depends on the severity of the disorder, the patient's age and general health, and bone marrow health.

What is the treatment of high WBC? ›

Hydroxyurea (Hydrea®) is sometimes given to lower very high WBC counts rapidly until a CML diagnosis is confirmed through blood and bone marrow tests. Hydroxyurea is taken as a capsule by mouth. Lowering those very high WBC counts can help reduce the size of the spleen.

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