The feedback from high white blood cells (more properly: high leukocytes, WBC highs or leukocytosis) is very common, and is often linked to the presence of an infectious state or to blood diseases. The causes of high leukocytes they are in fact above all states of secondary inflammation infections bacterial, fungal, viral or parasitic, but also diseases of the hematopoietic system such as leukemia and lymphoproliferative syndromes, or a state of dehydration. THE symptoms of high white blood cells they are very varied, and generally asthenia (tiredness), malaise, fever. Very often, however, there is no specific symptom associated with high white blood cells.
High white blood cells or leukocytes - Leukocytosis
What are the White blood cells? White blood cells or leukocytes (in English WBC, that is white blood cells) are very important cells, necessary for the defense of our organism from attacks by foreign agents or organisms such as bacteria, viruses, parasites and fungi (fungi).
White blood cells are divided into numerous subtypes, classified according to the shape of the nucleus and the response to specific colors used for viewing under the microscope.
There leukocyte formula, which is nothing more than the percentage determination of the various cell types of leukocytes present in the peripheral smear of our blood, is mainly composed of lymphocytes and granulocytes. Let's see in detail the composition of the leukocyte formula.
- THE polymorphonuclear granulocytes they represent the majority of total leukocytes, and are so named for the presence of characteristic granules in the cytoplasm (which is the liquid contained in the cells) and a polylobed nucleus (ie with many lobes). Granulocytes are represented by neutrophil granulocytes (60% of total white blood cells), i basophilic granulocytes (About 1% of total leukocytes) and i eosinophilic granulocytes (Approximately 5% of total white blood cells).
- Mononuclear agranulocytes, on the other hand, represent about 35% of total white blood cells, and are characterized by a rounded nucleus and by the scarcity or absence of granules in the cytoplasm. The main types of mononuclear leukocytes are i lymphocytes (30% of total white blood cells) ei monocytes (Approximately 6% of total WBCs), which are the circulating cells from which macrophages are derived.
In turn, the lymphocytes are divided into sub-categories with very different functions:
- THE B lymphocytes, that is the plasma cells, are the lymphocytes that primarily produce antibodies, as well as contribute to the activation of T lymphocytes.
- THE T lymphocytes They are divided into T Helper lymphocytes, essential for the activation and modulation of the immune response of other lymphocytes, and i cytotoxic T lymphocytes, which have a direct action on bacteria, viruses and other hostile agents to the organism.
High leukocytes - High white blood cells - Leukocytosis values
High leukocyte values (leukocytosis) are values higher than 11 * 10 ^ 9 / l, that is, more than 11 billion white blood cells per liter of blood.
In some laboratories this number is expressed as 11,000 leukocytes / mm3 or ml, i.e. values greater than eleven thousand white blood cells per cubic millimeter or milliliter of blood.
High White Blood Cells Causes - High White Blood Cells Causes - Leukocytosis Causes
What are the main causes of leukocytosis (i.e. the causes of high white blood cells in the blood)?
The main ones causes of high leukocytes I'm:
- Bacterial infections: they are the type of infection that most frequently causes an increase in total white blood cells, and in particular in neutrophilic granulocytes (neutrophilia). In the presence of bacteria, our body produces a large amount of pro-inflammatory cytokines and medullary growth factors, resulting in the production and release of white blood cells. Note: Not all bacterial infections cause leukocytosis: for example, typhoid fever causes leukopenia, neutropenia, or both. Other bacterial infections that can cause neutropenia include Staphylococcus aureus or Mycobacterium tuberculosis infections, brucellosis, tularemia, rickettsiae infections and leishmaniasis. The main bacterial infections associated with high white blood cells are:
- Urinary infections (cystitis, pyelonephritis, urethritis),
- Airway infections (pneumonia, bronchitis, bronchiolitis, pharyngitis, laryngitis, sinusitis). Bronchiolitis, for example, is a common cause of leukocytosis in children.
- Dental and oral infections (tonsillitis, granulomas or dental abscesses),
- Skin infections (erysipelas, cellulite, fasciitis).
- THEviral infectionsInfections caused by viruses are the most common infectious diseases and cause alterations in the percentage and quantitative composition of leukocytes, often causing an increase in lymphocytes (lymphocytosis). The most common viral infections are
- acute viral infections, such as those of influenza ((influenza and parainfluenza viruses), colds (rinhovirus), mononucleosis (EBV or Epstein Barr virus), CMV or Cytomegalovirs infection), childhood infections such as mumps and rubella , acute viral hepatitis such as hepatitis A) HAV) and hepatitis E (HEV).
- chronic viral infections such as chronic hepatitis virus infections (hepatitis virus HBV, HCV, HDV), the frequent and widespread herpes labialis or genital (herpes virus 1 and 2 infection) and HIV, responsible for the acquired immunodeficiency syndrome, the AIDS.
- Fungal infections: Fungal infections are less frequent than bacterial and viral fictions, but they affect a non-indifferent number of people (think of Candida in women), and are often responsible for an increase in circulating leukocytes (especially the proportion of neutrophilic granulocytes).
- Parasite infections: parasites, such as intestinal infections due to Tenia solium or Toxocara, or toxoplasmosis in immunosuppressed people, cause an increase in the count of lymphocytes and especially of eosinophilic granulocytes.
- Blood tumors, which affect the bone marrow and alter the production of blood cells:
- Leukemia: leukemias are a group of diseases of the hematopoietic system, which differ according to the speed with which they occur (acute leukemias and chronic leukemias), as well as according to the type of white blood cell involved (myeloid leukemias and lymphatic or lymphoid leukemias). In leukemias it happens that a clone (a particular "strain") of mutated cells begins to multiply in an uncontrolled way. If one of the leukocyte precursors is affected, the disease will lead to a concentration of white blood cells, often immature and poorly functioning) even tens of times higher than normal. 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.
- Lymphomas: they are mainly classified into Hodgkin's lymphomas and non-Hodgkin's lymphomas depending on the presence or absence of some particular cells (Reed Stemberg cells). They are, trivialized, "solid state leukemia", with the disease affecting mainly the organs of the immune system such as lymph nodes, spleen and intestinal immunological stations.
- Myeloproliferative syndromes: haematological diseases secondary to a malfunctioning stem cell, which causes uncontrolled clonal proliferation. Myeloproliferative syndromes include various types of blood disorders, including chronic myeloid leukemia (CML, often classified as leukemias rather than myeloproliferative), polycythemia vera (PV), essential thrombocythemia (TE), and idiopathic myelofibrosis ( MFI).
- Solid tumors: the presence of solid neoplasms can lead to an inflammatory response by our body, with the release of pro-inflammatory proteins such as cytokines and circulating growth factors which can stimulate the marrow to produce a greater number of leukocytes (especially T and B). This increase in white blood cells is called paraneoplastic leukocytosis, as it is secondary to the presence of cancer.
- Dehydration: it is an apparently trivial cause, but in reality extremely frequent. Dehydration causes an increase in the concentration of all cells and substances present in the blood: we will have high hemoglobin, hematocrit increased, increased blood platelets (platelets), high white blood cells (leukocytosis), elevated creatinine, azotemia and so on.
- Medicines which increase circulating leukocytes:
- Corticosteroids: normally called with the generic term of cortisone, corticosteroids have an immunosuppressive action, but at the same time they stimulate the production of neutrophil granulocytes, so during their use it is not uncommon to find an increase in neutrophils and total white blood cells, especially in the initial stages of therapy.
- Prostaglandin (PGE 1): In neonates with duct-dependent congenital heart disease, the administration of prostaglandins can cause a reversible increase in neutrophilic granulocyte white blood cells.
- Lithium: lithium carbonate, often used in the treatment of depression and bipolar disorder, is known to cause mild leukocytosis with neutrophilia (with final values even double the reference values). The global increase in leukocytes is due to an increase in the production of neutrophils.
- Heparin: Heparin is an anticoagulant drug, which can be administered subcutaneously or intravenously depending on the formulation. Heparin can alter the blood count, mainly by increasing white blood cells (leukocytosis), and, more rarely, neutrophilic granulocytes (neutrophilia), and by reducing platelets (thrombocytopenia).
- Antiepileptic drugs: anticomitial drugs, such as phenytoin, carbamazepine or phenobarbital have been reported as possible triggers of a hypersensitivity reaction called a “drug reaction with eosinophilia and systemic symptoms” (DRESS). The increase in eosinophilic and neutrophil granulocytes and the consequent increase in total white blood cells are secondary to a drug hypersensitivity reaction. On the other hand, some patients develop an isolated increase in lymphocytes and / or a general decrease in circulating white blood cells.
- Clozapine: antipsychotic drug, known to cause agranulocytosis (major reduction in the production and blood circulation of granulocyte white blood cells). More rarely it can result in a dose-dependent increase in leukocytes and neutrophil counts.
- Minocycline: it is an antibiotic from the tetracyclines group, it is usually used for the treatment of acne and can cause an increase in plasma 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:
- Systemic lupus erythematosus (SLE): it is a chronic disorder with autoimmune pathogenesis, which can attack different organisms, with the pathogenetic mechanism of type III hypersensitivity, characterized by the formation of circulating immune complexes. SLE is frequently accompanied by leukocytosis.
- Rheumatoid arthritis: it is a chronic, progressive inflammatory polyarthritis of an autoimmune nature, the causes of which are not yet fully understood, mainly affecting the synovial joints (ie those with a synovial membrane). It can cause pain and deformation in the joint, which can lead to loss of function of the affected limb or segment.
- Autoimmune hyperthyroidism (Graves' disease): increased thyroid activity (on blood tests we will find high TSH, low fT3, low fT4, anti-TSH and / or anti-TPO antibody positivity and anti thyroglobulin).
- Vasculitis: vasculitis is an inflammation of the blood vessel wall, the most frequent are Wegener's granulomatosis, Takayasu's arteritis, Churg-Strauss syndrome, temporal arteritis (also called Horton's giant cell arteritis), Kawasaki disease, Scholein-Henoch purpura and cryoglobulin vasculitis.
- Chronic inflammatory bowel diseases: in English they are defined as Inflammatory bowel disease (IBD), they are distinguished in Crohn's disease and ulcerative colitis, they manifest themselves with inflammation and chronic damage to the gastrointestinal system, especially to the final part of the intestine (colon and rectus-sigma ). IBDs have a chronic course, presenting with pause periods alternating with phases of exacerbation, and often involve a state of mild leukocytosis.
- Premature birth: in children born prematurely, especially in infants under 1 kg in weight, a leukemoid syndrome, or an increase in leukocytes, which simulates (and therefore is not!) the beginning of a leukemia.
- Allergy: in the presence of an allergic reaction, whether it is an expression of seasonal allergies (grasses), from substances such as mites or animal fur, or acute allergic reactions (to drugs or foods), an increase in neutrophil granulocytes (eosinophilia ), which often also increases the amount of total circulating lymphocytes.
- Down syndrome: Babies with Down syndrome often have leukocytosis, neutrophilia and an increase in immature forms of leukocytes (blasts) in the blood during the period immediately following birth. In most cases this change is transient (referred to as transient myeloproliferative disease); however, children with Down syndrome than others develop acute leukemia more frequently.
- Familial cold urticariaAlso called familial autoinflammatory cold syndrome, it is an autosomal dominant inherited disease characterized by periodic rashes (rashes) with blisters and blisters, arthralgia (joint pain), fever and high white blood cells.
- 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.
- Familial neutrophilia, is a hereditary syndrome that is accompanied by leukocytosis with an increase in neutrophils, is linked to a mutation of the CSF3R gene.
- Dermatological diseases such as dermatitis herpetiformis or bullous pemphigus can cause eosinophilia and leukocytosis.
- Hypereosinophilic syndrome: clonal hematopoiesis disease characterized by peripheral blood eosinophilia> 1500 / mL and an increase in eosinophils in the hematopoietic bone marrow tissue for a period of more than six months and in the absence of clinical conditions capable of causing eosinophilia, is always linked to an acquired somatic mutation arising in a hematopoietic stem cell.
- Monocytosis: the isolated increase in monocytes, if relevant, can also lead to a global increase in WBCs. The finding of high monocytes is caused by bacterial infections such as endocarditis and brucellosis, mycobacterial infections such as tuberculosis, viral infections such as mononucleosis and rickettsial infections such as Rocky Mountain fever. Some cancers may also be associated with elevated monocytes, such as lung cancers, leukemias, lymphomas, and myeloproliferative syndromes.
- Basophilia: Isolated increase in basophilic granulocytes is very rare, and is generally associated with acute or chronic myeloid leukemia.
High White Blood Cell Symptoms - High White Blood Cell Symptoms - Leukocytosis Symptoms
What are the symptoms of high white blood cells? The main symptoms of elevated leukocytes I'm:
- fatigue: the medical term is asthenia, it means weakness even in carrying out common daily activities
- weight loss: the medical term is weight loss, it means weight loss
- signs and symptoms of infection such as
- arthralgia: pain in the joints
- dysuria: urinary pain or burning
- pharyngodynia: sore throat
- widespread pains: the so-called "bone ache" typical of the flu
- abdominal pain, ie abdominal pain
- hyperpyrexia, ie fever
- pallor of the skin, mucous membranes (lips, conjunctivae) and nails
- hepatomegaly: increase in the size of the liver
- headache, it can be headache or migraine
- frequent bleeding, especially gum bleeding or epistaxis (nosebleeds).
- kidney failure: confirmation of high creatinine due to the overload of the products of lysis of red blood cells and blasts (immature white blood cells) at the level of the kidneys.
Leukocytosis - White Blood Cells or Elevated Leukocytes: What to Do?
What should i do if i have high leukocytes in the tests?
[sociallocker id = 1435] In the event of an elevated leukocyte, the first thing to do is to show your GP the blood tests with the altered values. The doctor will assess the situation, evaluate your symptoms and signs (if you have any), will visit you and, if appropriate, will prescribe further blood tests or instrumental investigations. [/ Sociallocker]