Sandbox: Leukocytosis
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]
Synonyms and keywords:
Overview
Leukocytosis is white blood cells (the leukocyte count) above the normal range in the blood.[1][2] It is frequently a sign of an inflammatory response,[3] most commonly the result of infection, but may also occur following certain parasitic infections or bone tumors. It may also occur after strenuous exercise, convulsions such as epilepsy, emotional stress, pregnancy and labour, anesthesia, and epinephrine administration.[1]
There are five principal types of leukocytosis:[4]
- Neutrophilia (the most common form)[5]
- Lymphocytosis
- Monocytosis
- Eosinophilia
- Basophilia
This increase in leukocyte (primarily neutrophils) is usually accompanied by a "left shift" in the ratio of immature to mature neutrophils. The proportion of immature leukocytes increases due to proliferation and release of granulocyte and monocyte precursors in the bone marrow which is stimulated by several products of inflammation including C3a and G-CSF. Although it may indicate illness, leukocytosis is considered a laboratory finding instead of a separate disease. This classification is similar to that of fever, which is also a test result instead of a disease.[citation needed] "Right shift" in the ratio of immature to mature neutrophils is considered with reduced count or lack of "young neutrophils" (metamyelocytes, and band neutrophils) in blood smear, associated with the presence of "giant neutrophils". This fact shows suppression of bone marrow activity, as a hematological sign specific for pernicious anemia and radiation sickness.[6]
Historical Perspective
- Leukocytosis was first discovered by [scientist name], a [nationality + occupation], in [year] during/following [event].
Classification
- Leukocytosis may be classified according to [classification method] into [number] subtypes/groups:
- [group1]
- [group2]
- [group3]
Pathophysiology
- The pathogenesis of leukocytosis is characterized by [feature1], [feature2], and [feature3].
- The [gene name] gene/Mutation in [gene name] has been associated with the development of leukocytosis, involving the [molecular pathway] pathway.
- On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of leukocytosis.
Causes
- To see causes of leukocytosis, please click here
Epidemiology and Demographics
- The prevalence of leukocytosis is approximately [number or range] per 100,000 individuals worldwide.
- In [year], the incidence of leukocytosis was estimated to be [number or range] cases per 100,000 individuals in [location].
Age
- Patients of all age groups may develop leukocytosis.
- Leukocytosis is more commonly observed among patients aged [age range] years old.
- Leukocytosis is more commonly observed among [elderly patients/young patients/children].
Gender
- Leukocytosis affects men and women equally.
- [Gender 1] are more commonly affected with leukocytosis than [gender 2].
- The [gender 1] to [Gender 2] ratio is approximately [number > 1] to 1.
Race
- There is no racial predilection for leukocytosis.
- Leukocytosis usually affects individuals of the [race 1] race.
- [Race 2] individuals are less likely to develop leukocytosis.
Risk Factors
- Common risk factors in the development of leukocytosis, include:
Natural History, Complications and Prognosis
- The majority of patients with leukocytosis remain asymptomatic for [duration/years].
- Early clinical features include [manifestation 1], [manifestation 2], and [manifestation 3].
- If left untreated, [#%] of patients with leukocytosis may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
- Common complications of leukocytosis include [complication 1], [complication 2], and [complication 3].
- Prognosis is generally [excellent/good/poor], and the [1/5/10year mortality/survival rate] of patients with leukocytosis is approximately [#%].
Diagnosis
Symptoms
- Leukocytosis is usually asymptomatic.
- Symptoms of leukocytosis may include the following:
- [symptom 1]
- [symptom 2]
- [symptom 3]
- [symptom 4]
- [symptom 5]
- [symptom 6]
Laboratory Findings
- Laboratory findings consistent with the diagnosis of leukocytosis include [abnormal test 1], [abnormal test 2], and [abnormal test 3].
Other Diagnostic Studies
- Leukocytosis may also be diagnosed using [diagnostic study name].
- Findings on [diagnostic study name] include [finding 1], [finding 2], and [finding 3].
Treatment
Medical Therapy
- There is no treatment for leukocytosis; the mainstay of therapy is supportive care.
- The mainstay of therapy for leukocytosis is [medical therapy 1] and [medical therapy 2].
- [Medical therapy 1] acts by [mechanism of action1].
- Response to [medical therapy 1] can be monitored with [test/physical finding/imaging] every [frequency/duration].
References
- ↑ 1.0 1.1 Rogers, Kara, ed. (2011), "Leukocytosis definition", Blood: Physiology and Circulation, Chicago: Britannica Educational Publishing, p. 198, ISBN 978-1-61530-250-5, retrieved 12 November 2011
- ↑ TheFreeDictionary > Leukocytosis Citing: Gale Encyclopedia of Medicine, 2008 and The American Heritage Medical Dictionary, 2007
- ↑ Porth, Carol Mattson (2011), "White blood cell response", Essentials of Pathophysiology: Concepts of Altered Health States (3rd ed.), Philadelphia: Wolters Klower Health/Lippincott Williams & Wilkins, pp. 64–65, ISBN 978-1-58255-724-3, retrieved 13 November 2011
- ↑ Zorc, Joseph J, ed. (2009), "Leukocytosis", Schwartz's Clinical Handbook of Pediatrics (4th ed.), Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins, p. 559, ISBN 978-0-7817-7013-2, retrieved 12 November 2011
- ↑ Schwartz, M. William, ed. (2003), "Leukocytosis", The 5-Minute Pediatric Consult (3rd ed.), Philadelphia: Lippincott Williams & Wilkins, p. 54, ISBN 0-7817-3539-4, retrieved 12 November 2011
- ↑ Lutan, Vasile. Fiziopatologie medicală. Vol. 2, 31.3.2.1. Leucocitozele; http://library.usmf.md/ebooks.php?key=b11