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Differentiating Leukocytosis from Other Diseases

  • Leukocytosis is defined as an elevated white blood cell (WBC) count greater than 11,000 per mm3 (11.0 × 109 per L).
  • The most common type of leukocytosis is neutrophilia.
    • Neutrophilia can be defined as an increase in the absolute number of mature neutrophils to greater than 7,000 per mm3 [7.0 × 109 per L].
Category Condition Etiology Mechanism Congenital Acquried Clinical manifestations Para−clinical findings Gold standard Associated findings
Demography History Symptoms Signs
Lab Findings
Physiologic increased bone marrow production demargination of peripheral blood neutrophils Appearance Fever Abdominal pain BP Asplenia Hepatosplenomegaly Lymphadenopathy Joint redness Other CBC PBS Bone marrow exam ESR/CRP BUN/Cr LFT
autonomous reactive WBC HB Plt
Hematologic Hereditary neutrophilia
Hereditary chronic neutrophilia
Myeloproliferative neoplasms
Polycythemia Vera
Microangiopathic hemolytic anemia (MAHA)
Leukoerythroblastosis
Immature thrombocytopenia
Immunology/

Rheumatology

Condition Etiology Physiologic Autonomous increased bone marrow production Reactive increased bone marrow production demargination of peripheral blood neutrophils Congenital Acquried Demography History Appearance Fever Abdominal pain BP Asplenia Hepatosplenomegaly Lymphadenopathy Joint redness Other signs WBC HB Plt PBS Bone marrow exam ESR/CRP BUN/Cr LFT Gold standard Associated findings
Leukocyte adhesion deficiency
Cryopyrin-associated periodic syndromes
Rheumatoid arthritis
Juvenile onset rheumatoid arthritis
adult Still's disease
Kawasaki disease
IBD
Sarcoidosis
Chronic hepatitis
Sweet syndrome
Acute Gout
Infections Acute bacterial toxic granulations, Döhle bodies, and cytoplasmic vacuoles in neutrophils
Chronic
Viral infection
granulomatous infections
bronchiectasis
Metabolic Diabetic coma
Acidosis
Thyroid strom
Hypercortisolism
Seizures
Category Condition Etiology Physiologic Autonomous increased bone marrow production Reactive increased bone marrow production demargination of peripheral blood neutrophils Congenital Acquried Demography History Appearance Fever Abdominal pain BP Asplenia Hepatosplenomegaly Lymphadenopathy Joint redness Other signs WBC HB Plt PBS Bone marrow exam ESR/CRP BUN/Cr LFT Gold standard Associated findings
Medications Steriod Release of granulocytes from the bone marrow
myeloid growth factors
Lithium
Beta agonists
Cytokines
Catecholamines (epinephrine) Stimulation of bone marrow myelopoiesis and/or egress into the circulation
ATRA
Other Allergy
Post splenectomy
Down syndrome
Cigarette smoking
Stress/Exercise
Infancy
Pregnancy
Platelet clumping Spurious
Mixed cryoglobulinemia Spurious
Category Condition Etiology Physiologic Autonomous increased bone marrow production Reactive increased bone marrow production demargination of peripheral blood neutrophils Congenital Acquried Demography History Appearance Fever Abdominal pain BP Asplenia Hepatosplenomegaly Lymphadenopathy Joint redness Other signs WBC HB Plt PBS Bone marrow exam ESR/CRP BUN/Cr LFT Gold standard Associated findings