HIGH LYMPHOCYTES - LYMPHOCYTOSIS symptoms and causes

THE lymphocytes I'm a type of white blood cell, which increases in the blood mainly due to infections, especially viral infections, and during hematological diseases. THE symptoms of elevated lymphocytes they are related to the underlying disease that caused the biohumoral alteration.

High lymphocytes

What are lymphocytes? THE lymphocytes are particular types of white blood cells, and are the main cells responsible foracquired immunity, that is, those cells capable of precisely and selectively fighting a particular antigen (fragment of substance or microorganism that is recognized and attacked by the lymphocyte).

At the first exposure of the antigen the response times are quite long, but thanks to the conservation of one immunological memory subsequent attacks are conducted much faster and more effectively, and it is on this principle that the vaccinations.

Only a small part of the total lymphocytes is actually present in the bloodstream, since most of the lymphocyte patrimony is instead contained in the lymphatic tissues (lymph nodesspleen is thyme).

In lymphatic tissues, lymphocytes are made to "mature" in order to be ready to attack antigens foreign to the body through continuous solutions of the skin (wounds) or through the mucous membranes (for example mouth or nose). In the presence of an infection or foreign substances, the lymphocytes multiply quickly, also swelling the lymph nodes that contain them (lymphadenomegaly or adenopathies).

Types of lymphocytes

There are various types of lymphocytes. Let's see briefly what are the main lymphocytes and what they are for.

  • B lymphocytes: they are lymphocytes responsible for the production and typing of immunoglobulins (ie antibodies, the most common forms of which are IgG and IgM) essential for the realization of the biohumoral immune response. In the final stage of maturation the B lymphocytes transform into plasma cells, under the regulatory influence of T lymphocytes.
  • T lymphocytes: they are mainly responsible for cell-mediated immunity, the name T lymphocyte comes from the word thymus, the mediastinal organ in which the T lymphocytes carry out the first part of the maturation, returning to the circulation with naive lymphocytes, i.e. virgin T lymphocytes that have not yet met the antigen, Subsequently, according to the type of major histocompatibility complex (MHC) which will present them with the antigen, they further differentiate into CD8 cytotoxic T lymphocytes (antigen presented by MHC class I) e CD4 T Helper lymphocytes (antigen presented by MHC class II).
  • NK cells: NK lymphocytes, or cells Natural Killer.

High Lymphocytes Causes - Lymphocytosis Causes

What are the main ones causes of lymphocytosis (i.e. the causes of high blood lymphocytes)?

The main causes of high lymphocytes are:

  • Viral infections: secondary virus infections are the most frequent infectious pathologies of all, and are the cause of alterations in the leukocyte formula, especially with an increase in the lymphocytic fraction (lymphocytosis). Note: it is not uncommon for viral infections to be found in blood tests of high lymphocytes and low neutrophils. The most frequent viral infections are
    • acute infections, such as those from EBV (Epstein Barr virus, responsible for the transmission of mononucleosis, the so-called kissing disease), from influenzavirus (the trivial flu) and from rinhovirus and adenovirus (the so-called cold), from CMV (cytomegalovirus), mumps, rubella and the infamous Ebola virus.
    • chronic infections such as hepatitis B virus (HBV), hepatitis C (HCV) infections, bothersome cold sores or genital herpes (herpes virus infection) and HIV, responsible for acquired immunodeficiency syndrome, (acquired immunodeficiency syndrome or AIDS) .
  • Bacterial infections: bacterial infections, although they are mainly responsible for leukocytosis secondary to an increase in neutrophilic granulocytes (neutrophilia), can also alter lymphocyte counts, especially infections with atypical germs (for example, respiratory infections with chlamydia pneumoniae or mycoplasma pneumoniae) or Brucellosis.
  • Mycobacterial Infections: TB (tuberculosis) is a non-negligible cause of lymphocyte elevation.
  • Fungal infections: Fungal infections, although less frequent than bacterial and viral infections, can rarely be responsible for an increase in circulating lymphocytes.
  • Parasite infections: Parasitic diseases, such as Toxoplasmosis or Tenia solium or Toxocara intestinal infections, cause an increase in eosinophil counts and, sometimes, lymphocytes.
  • Blood tumors, which affect the bone marrow and alter the production of blood cells:
    • Leukemia: they are distinguished on the basis of the rapidity of expression (acute leukemias and chronic leukemias), as well as on the type of cells affected (myeloid leukemias and lymphatic or lymphoid leukemias. In leukemias a clone of mutated cells begins to produce circulating cells in an uncontrolled way . If one of the leukocyte precursors is affected, the disease will lead to a concentration of white blood cells even tens of times higher than normal. Leukemias almost always cause a monoclonal lymphocytosis, that is, the uncontrolled multiplication of lymphocytes that are all the same, starting from a single altered lymphocyte clone. It is good to know that in the presence of leukemia, especially in the advanced stage of the disease, leukopenia can also occur, depending on the type of cell affected. Among the most common are:
      • Prolymphocytic leukemia (PLL): it is a form of leukemia with an aggressive but treatable course, it is a neoplastic disorder characterized by the proliferation of B prolymphocytes in the peripheral blood, marrow and spleen.
      • Hairy Cell Leukemia (HCL): it is a type of chronic lymphatic leukemia, characterized by the presence in the blood (but also in the spleen, in the bone marrow, in the liver, and sometimes in the lymph nodes) of an accumulation of proliferating lymphocytes which, upon microscopic observation, show characteristic filamentous offshoots of the cytoplasm. These offshoots are so thin that they resemble hair
      • Lymphomas leukemic expression: lymphomas are leukemias in which the solid component is greater than the circulating component, mainly affecting lymphatic organs such as spleen and lymph nodes
        Large T-cell granular lymphocytic leukemia: Lymphoproliferative disease characterized by clonal expansion of CD3 + CD8 + cytotoxic lymphocytes.
      • Acute lymphoblastic leukemia (ALL): is a type of blood cancer in which the bone marrow is replaced by more immature forms of white blood cells (blasts). ALL is a type of leukemia characterized by the presence of numerous immature forms of white blood cells, the lymphoblasts, produced in the bone marrow and released into the circulation. In lymphatic-type leukemia it is therefore not uncommon to find low neutrophils and high lymphocytes, due to the suppression of all hematopoietic chains with overproduction of the clone
      • Chronic lymphocytic leukemia (CLL): Chronic lymphocytic leukemia is a type of leukemia that is characterized by the presence of an excessive amount of immature lymphocytes, and is defined as chronic because it has a slower and more subtle course than ALL. It is the most common type of leukemia in adults, especially in the elderly, and mainly affects males more than females.
    • Lymphomas: they are a kind of solid leukemia, with the disease mainly affecting the organs of the immune system such as lymph nodes, spleen and intestinal immunological stations. They are mainly classified into Hodgkin's lymphomas and non-Hodgkin's lymphomas. Often they are diagnosed secondary to the finding of elevated lymphocytes on blood tests.
    • Myeloproliferative syndromes: Blood diseases derived from a diseased stem cell, with uncontrolled proliferation of the pathological clone, include various types of blood pathology, including chronic myeloid leukemia (CML, often classified as leukemias instead of myeloproliferative), polycythemia vera ( PV), essential thrombocythemia (TE), and idiopathic myelofibrosis (MFI).
  • Solid neoplasms: the presence of tumors can cause an inflammatory response by our body, with the release of cytokines and circulating growth factors that can stimulate the marrow to produce a greater number of leukocytes (especially lymphocytes). This leukocytosis is called paraneoplastic, as it is secondary to the presence of cancer.
  • Dehydration: trivial but very frequent cause, dehydration causes an increase in the concentration of all cells and substances in the blood: we will have high hemoglobin, hematocrit increased, platelets, leukocytosis, elevated creatinine, increased urea (azotemia) and so on.
  • Medicines which increase circulating leukocytes:
    • Heparin: Heparin, whether administered intravenously (calcium heparin for example) or subcutaneously (fractionated heparin or low molecular weight heparin, such as enoxaparin) can induce the development of leukocytosis, mainly due to an increase in white blood cells (lymphocytosis) , and, more rarely, of neutrophilic granulocytes (neutrophilia).
    • Antiepileptic drugs: anticomitial drugs, such as carbamazepine, phenobarbital and phenytoin can trigger a severe hypersensitivity reaction called a "drug reaction with eosinophilia and systemic symptoms" (Drug Reaction with Eosynophilia and Systemic Symptoms, DRESS), with a marked increase in eosinophilic granulocytes and neutrophils and that of the total white blood cells. Some patients also develop a selective increase in lymphocytes (lymphocytosis) or a general drop in white blood cells (leukopenia).
    • Minocycline: antibiotic belonging to the tetracycline class, it is commonly used for the treatment of acne and can give an increase in circulating lymphocytes and total leukocytes.
  • Autoimmune Diseases: some rheumatological diseases or diseases that affect the immune system can cause a state of perennial systemic inflammation, which helps to increase the production of blood cells in the marrow:
    • Rheumatoid arthritis: chronic, ankylosing and progressive inflammatory polyarthritis with autoimmune pathogenesis and cause not yet fully understood, mainly affecting the synovial joints. It can cause deformation and pain that can lead to loss of joint function.
    • Autoimmune hyperthyroidism (e.g. Graves' disease): increased thyroid function (usually accompanied by low TSH, increased thyroid hormones and anti-TSH, and / or anti-TPO and anti-TBG antibodies).
    • Systemic lupus erythematosus: Systemic lupus erythematosus (SLE, or simply lupus) is a chronic disease of an autoimmune nature, which can affect different organs and tissues of the body, through an attack of the immune system to the structures of our own organism, with the pathogenetic mechanism of hypersensitivity of III type, characterized by the formation of circulating immune complexes.
    • Vasculitis: vasculitis is an inflammation of the blood vessels, the most frequent are Wegener's granulomatosis, Takayasu's arteritis, Churg-Strauss syndrome, temporal arteritis (giant cell arteritis or Horton's arteritis), Kawasaki, Scholein-Henoch purpura, and cryoglobulinemic vasculitis. These are all pathologies that can be associated with leukocytosis with lymphocytosis.
  • Chronic inflammatory bowel diseases: also called Inflammatory bowel disease (IBD), they are basically Crohn's disease and ulcerative colitis, they involve inflammation and chronic damage to the gastrointestinal tract, especially to the final part of the intestine (colon and rectum). IBDs have a chronic or recurrent course, which occur with periods of latency alternating with phases of exacerbation, and often involve a state of mild leukocytosis with an increase in neutrophils and / or lymphocytes.
  • Premature birth: in premature infants, especially if weighing less than 1 kg, it is not uncommon to observe the so-called leukemoid syndrome, i.e. a significant increase in leukocytes, which simulates starting a leukemia.
  • Stress: in the presence of stressful situations, the endogenous release of corticosteroids and epinephrine (adrenaline) stimulates the marrow to produce a greater quantity of leukocytes.
  • Splenectomy: the absence of a spleen, whether congenital or secondary to surgical removal (splenectomy), is characterized by the loss of that natural reservoir of white blood cells and platelets, which will therefore be found in higher concentrations than normal.
  • Trauma: they are accompanied by leukocytosis with the same mechanism of stress.
  • Severe pain: as with trauma and psychophysical stress situations, pain is often characterized by the finding of elevated leukocytes in blood tests.
  • Whooping cough: although the population of our country is protected by the pertussis vaccine, it should be noted as the increase in unvaccinated people (migrants, people who refuse the vaccine) could make this fearful disease re-emerge.

High Lymphocytes Symptoms - Lymphocytosis Symptoms

What are the symptoms of high lymphocytes? The main symptoms of lymphocytosis are:

  • asthenia: tiredness, weakness in common daily activities
  • weight loss, weight loss
  • signs and symptoms of infection such as
    • cough,
    • joint pain,
    • urinary burning
    • sore throat
  • bone pains
  • abdominal pain
  • temperature
  • pale skin, lips and nails
  • Hepatomegaly: enlarged liver
  • Headache: headache.
  • Frequent bleeding, especially gum bleeding or epistaxis (nosebleeds).
  • Renal failure: finding of high creatinine following the overload of the lysis products of red blood cells and blasts (immature white blood cells) in the kidneys.
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1 Comment
  1. Roberta Giansante 4 years ago

    Interesting article however for autoimmune diseases such as Basedow's disease please correct the tsh value which is low while thyroid hormones are high. Greetings

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