Leukocytosis is an increased number of leukocytes, or white blood cells (WBCs), in the blood. 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. Absolute neutrophilia refers to the increase in the total number of leukocytes in the blood as well as an increased percentage of neutrophils. This results in a neutrophil count of over 8,000.
Neutrophils are produced in the bone marrow, released into the blood, circulate briefly, and migrate into tissue spaces and onto epithelial surfaces. Injury, bacterial invasion of tissue or other causes results in the production and release of colony-stimulating factors, which increase proliferation and maturation of neutrophilic precursor cells in the bone marrow.
Other mediators of inflammation stimulate bone marrow release and promote margination and adhesion of neutrophils to vascular endothelium at the site of inflammation. The time for production of new cells from the bone marrow is 4 to 6 days. Neutrophils circulate for about 10 hours and are then compartmentalized into a circulating neutrophil pool (CNP) and a marginal neutrophil pool (MNP). Neutrophils in the CNP circulate with other blood cells and are measured in the CBC. The MNP consists of neutrophils that are intermittently adherent to endothelium, especially in small veins and capillaries.
Movement of neutrophils into tissues occurs randomly and is a one way process. Neutrophils are destroyed in the spleen, liver, and bone marrow. The number of circulating neutrophils are affected by the rate of bone marrow production and release, the rate of exchange between CNP and MNP, and the rate of migration into tissue. Neutrophilia results when the rate of marrow production and release increases, neutrophils move from the MNP into the CNP, or the tissue demand for neutrophils increases.
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). 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.
Fear, excitement, and vigorous exercise cause epinephrine release. Neutrophils demarginate from MNP into CNP, resulting in a transient (1 hour), mature neutrophilia.
Corticosteriods, whether from stress or when using drugs like prednisone, cause increased bone marrow release of mature neutrophils, movement into the CNP, and decreased tissue migration. An increase in white blood cells and neutrophilia occurs 4 to 8 hours after elevation of stress hormones or steroid use and return to normal 1 to3 days after later. Lymphopenia can occur concurrently.
Inflammation, sepsis, necrosis, and immune-mediated disease can cause increased tissue demand and increased bone marrow release of segmented and band neutrophils. Leukocytosis (15,000 to 30,000), neutrophilia with a left shift (the ratio of neutrophils to lymphocytes is high), toxic neutrophils, lymphopenia, eosinopenia, and variable monocytosis are seen often at the same time. Surgical removal or drainage of a septic focus may increase neutrophilia.
Risk factors for Neutrophilia
Allergy / Intolerance to Foods (Hidden)
An Increase in the neutrophil count has been seen during food challenge in milk-allergic children.
Recommendations for Neutrophilia
Antibiotics
Neutrophils are the primary white blood cells that respond to a bacterial infection, so the most common cause of marked neutrophilia is a bacterial infection.
Key
| Strong or generally accepted link |
| May do some good |
| Likely to help |
Glossary
Leukocyte
A white blood cell which appears 5,000 to 10,000 times in each cubic millimeter of normal human blood. Among the most important functions are destroying bacteria, fungi and viruses and rendering harmless poisonous substances that may result from allergic reactions and cell injury.
White Blood Cell
(WBC): A blood cell that does not contain hemoglobin: a blood corpuscle responsible for maintaining the body's immune surveillance system against invasion by foreign substances such as viruses or bacteria. White cells become specifically programmed against foreign invaders and work to inactivate and rid the body of a foreign substance. Also known as a leukocyte.
Bacteria
Microscopic germs. Some bacteria are "harmful" and can cause disease, while other "friendly" bacteria protect the body from harmful invading organisms.
Tuberculosis
Also known as TB, Consumption or "The White Plague", tuberculosis is an infectious disease caused by a bacterium called Mycobacterium tuberculosis, usually affecting the lungs but possibly also the brain, kidneys and bones. Patients may at first be symptom-free or experience a flu-like illness. In the secondary stage, there might be a slight fever, night sweats, weight loss, fatigue and various other symptoms, depending on the part of the body affected. Tuberculosis of the lung is usually associated with a dry cough that eventually leads to a productive cough with blood-stained sputum. There might also be chest pain and shortness of breath.
Rheumatoid Arthritis
A long-term, destructive connective tissue disease that results from the body rejecting its own tissue cells (autoimmune reaction).
Hemolysis
Breaking down of red blood cells.
Seizure
While there are over 40 types of seizure, most are classed as either partial seizures which occur when the excessive electrical activity in the brain is limited to one area or generalized seizures which occur when the excessive electrical activity in the brain encompasses the entire organ. Although there is a wide range of signs, they mainly include such things as falling to the ground; muscle stiffening; jerking and twitching; loss of consciousness; an empty stare; rapid chewing/blinking/breathing. Usually lasting from between a couple of seconds and several minutes, recovery may be immediate or take up to several days.
Cancer
Refers to the various types of malignant neoplasms that contain cells growing out of control and invading adjacent tissues, which may metastasize to distant tissues.
Hormones
Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.
Steroid
Any of a large number of hormonal substances with a similar basic chemical structure containing a 17-carbon 14-ring system and including the sterols and various hormones and glycosides.
Necrosis
Death of one or more cells, or of a portion of a tissue or organ.