Types and causes of leukocytosis, changes in the leukocyte formula, their prognostic significance. There are several types of physiological leukocytosis Leukocytosis physiology

Leukocytes

Leukocytes, or white blood cells, are colorless cells of varying sizes (from 6 to 20 microns), round or irregular in shape. These cells have a nucleus and are capable of independently moving like a single-celled organism - an amoeba. The number of these cells in the blood is significantly less than erythrocytes and in a healthy person is 4.0-8.8 x 10 9 / l. Leukocytes are the main protective factor in the human body’s fight against various diseases. These cells are “armed” with special enzymes capable of “digesting” microorganisms, binding and breaking down foreign protein substances and breakdown products formed in the body during vital activity. In addition, some forms of leukocytes produce antibodies - protein particles that attack any foreign microorganisms that enter the blood, mucous membranes and other organs and tissues of the human body.

There are two main types of white blood cells. In cells of one type, the cytoplasm has granularity, and they are called granular leukocytes - granulocytes. There are 3 forms of granulocytes: neutrophils, which, depending on the appearance of the nucleus, are divided into band and segmented, as well as basophils and eosinophils.

In the cells of other leukocytes, the cytoplasm does not contain granules, and among them there are two forms - lymphocytes and monocytes. These types of leukocytes have specific functions and change differently in various diseases (see below), so their quantitative analysis is a serious aid to the doctor in determining the causes of the development of various forms of pathology.

An increase in the number of leukocytes in the blood is called leukocytosis, and a decrease is called leukopenia.

Leukocytosis can be physiological, i.e. occurs in healthy people in some quite ordinary situations, and pathological when it indicates some kind of disease.

Physiological leukocytosis observed in the following cases:

• 2-3 hours after eating - digestive leukocytosis;
• after intense physical work;
• after hot or cold baths;
• after psycho-emotional stress;
• in the second half of pregnancy and before menstruation.

For this reason, the number of leukocytes is examined in the morning on an empty stomach in a calm state of the subject, without previous physical activity, stressful situations, or water treatments.

To the most common reasons pathological leukocytosis include the following:

• various infectious diseases: pneumonia, otitis media, erysipelas, meningitis, pneumonia, etc.;
• suppuration and inflammatory processes of various localizations: pleura (pleurisy, empyema), abdominal cavity (pancreatitis, appendicitis, peritonitis), subcutaneous tissue (felon, abscess, phlegmon), etc.;
• fairly large burns;
• infarctions of the heart, lungs, spleen, kidneys;
• conditions after severe blood loss;
• leukemia;
• chronic renal failure;
• diabetic coma.

It must be remembered that in patients with weakened immunity (senile people, exhausted people, alcoholics and drug addicts), leukocytosis may not be observed during these processes. The absence of leukocytosis during infectious and inflammatory processes indicates a weak immune system and is an unfavorable sign.

Leukopenia- a decrease in the number of leukocytes in the blood below 4.0 x 10 9 /l in most cases indicates inhibition of the formation of leukocytes in the bone marrow. More rare mechanisms for the development of leukopenia are increased destruction of leukocytes in the vascular bed and redistribution of leukocytes with their retention in depot organs, for example, during shock and collapse.

Most often, leukopenia is observed due to the following diseases and pathological conditions:

• exposure to ionizing radiation;
• taking certain medications: anti-inflammatory drugs (amidopyrine, butadione, pyrabutol, reopirin, analgin); antibacterial agents (sulfonamides, synthomycin, chloramphenicol); drugs that inhibit thyroid function (mercazolyl, propicyl, potassium perchlorate); drugs used for the treatment of oncological diseases - cytostatics (methotrexate, vincristine, cyclophosphamide, etc.);
• hypoplastic or aplastic diseases, in which, for unknown reasons, the formation of leukocytes or other blood cells in the bone marrow is sharply reduced;
• some forms of diseases in which the function of the spleen increases (hypersplenism), liver cirrhosis, lymphogranulomatosis, tuberculosis and syphilis, occurring with damage to the spleen;
• selected infectious diseases: malaria, brucellosis, typhoid fever, measles, rubella, influenza, viral hepatitis;
• systemic lupus erythematosus;
• anemia associated with vitamin B12 deficiency;
• in oncopathology with metastases to the bone marrow;
• in the initial stages of development of leukemia.

The leukocyte formula is the ratio of different forms of leukocytes in the blood, expressed as a percentage. Standard values ​​of the leukocyte formula are presented in table. 1.

Table 1 Leukocyte formula of blood and the content of various types of leukocytes in healthy people

The name of the condition in which an increase in the percentage of one or another type of leukocyte is detected is formed by adding the ending “-iya”, “-oz” or “-ez” to the name of this type of leukocyte (neutrophilia, monocytosis, eosinophilia, basophilia, lymphocytosis).

A decrease in the percentage of various types of leukocytes is indicated by adding the ending “-singing” to the name of this type of leukocyte (neutropenia, monocytopenia, eosinopenia, basopenia, lymphopenia).

To avoid diagnostic errors when examining a patient, it is very important for the doctor to determine not only the percentage of different types of leukocytes, but also their absolute number in the blood. For example, if the number of lymphocytes in the leukoformula is 12%, which is significantly lower than normal, and the total number of leukocytes is 13.0 x 10 9 / l, then the absolute number of lymphocytes in the blood is 1.56 x 10 9 / l, i.e. " fits" into the normative meaning.

For this reason, a distinction is made between absolute and relative changes in the content of one or another form of leukocytes. Cases when there is a percentage increase or decrease in various types of leukocytes with their normal absolute content in the blood are designated as absolute neutrophilia (neutropenia), lymphocytosis (lymphopenia), etc. In those situations where both the relative (in %) and the absolute number of certain forms of leukocytes speaks of absolute neutrophilia (neutropenia), lymphocytosis (lymphopenia), etc.

Different types of leukocytes “specialize” in different protective reactions of the body, and therefore analysis of changes in the leukocyte formula can tell a lot about the nature of the pathological process that has developed in the body of a sick person and help the doctor make a correct diagnosis.

Neutrophilia, as a rule, indicates an acute inflammatory process and is most pronounced in purulent diseases. Since inflammation of an organ in medical terms is indicated by adding the ending “-itis” to the Latin or Greek name of the organ, neutrophilia appears in pleurisy, meningitis, appendicitis, peritonitis, pancreatitis, cholecystitis, otitis, etc., as well as acute pneumonia, phlegmon and abscesses of various locations, erysipelas.

In addition, an increase in the number of neutrophils in the blood is detected in many infectious diseases, myocardial infarction, stroke, diabetic coma and severe renal failure, after bleeding.

It should be remembered that neutrophilia can be caused by taking glucocorticoid hormonal drugs (dexamethasone, prednisolone, triamcinolone, cortisone, etc.).

Band leukocytes react most to acute inflammation and purulent process. A condition in which the number of leukocytes of this type in the blood increases is called a band shift, or a shift of the leukocyte formula to the left. Band shift always accompanies severe acute inflammatory (especially suppurative) processes.

Neutropenia observed in some infectious (typhoid fever, malaria) and viral diseases (influenza, polio, viral hepatitis A). A low level of neutrophils often accompanies severe inflammatory and purulent processes (for example, in acute or chronic sepsis - a serious disease when pathogenic microorganisms enter the blood and freely settle in internal organs and tissues, forming numerous purulent foci) and is a sign that worsens the prognosis of severe sick.

Neutropenia can develop when bone marrow function is suppressed (aplastic and hypoplastic processes), with B12-deficiency anemia, exposure to ionizing radiation, as a result of a number of intoxications, including when taking drugs such as amidopyrine, analgin, butadione, reopirin, sulfodimethoxine, biseptol, chloramphenicol, cefazolin, glibenclamide, mercazolil, cytostatics, etc.

If you noticed, the factors leading to the development of leukopenia simultaneously reduce the number of neutrophils in the blood.

Lymphocytosis characteristic of a number of infections: brucellosis, typhoid and relapsing endemic typhus, tuberculosis.

In patients with tuberculosis, lymphocytosis is a positive sign and indicates a favorable course of the disease and subsequent recovery, while lymphopenia worsens the prognosis in this category of patients.

In addition, an increase in the number of lymphocytes is often detected in patients with reduced thyroid function - hypothyroidism, subacute thyroiditis, chronic radiation sickness, bronchial asthma, B12-deficiency anemia, and fasting. An increase in the number of lymphocytes has been described when taking certain drugs.

Lymphopenia indicates immunodeficiency and is most often detected in persons with severe and long-term infectious and inflammatory processes, the most severe forms of tuberculosis, acquired immunodeficiency syndrome, with certain forms of leukemia and lymphogranulomatosis, prolonged fasting leading to the development of dystrophy, as well as in persons who chronically abuse alcohol, substance abusers and drug addicts.

Monocytosis is the most characteristic sign of infectious mononucleosis, and can also occur with some viral diseases - infectious mumps, rubella. An increase in the number of monocytes in the blood is one of the laboratory signs of severe infectious processes - sepsis, tuberculosis, subacute endocarditis, some forms of leukemia (acute monocytic leukemia), as well as malignant diseases of the lymphatic system - lymphogranulomatosis, lymphoma.

Monocytopenia detected in cases of bone marrow damage - aplastic anemia and hairy cell leukemia.

Eosinopenia can be observed at the height of the development of infectious diseases, Bi2 deficiency anemia and damage to the bone marrow with a decrease in its function (aplastic processes).

Basophilia usually detected in chronic myelodeicosis, decreased thyroid function (hypothyroidism), and a physiological increase in basophils in the premenstrual period in women has been described.

Basopenia develops with increased function of the thyroid gland (thyrotoxicosis), pregnancy, stress, Itsenko-Cushing syndrome - a disease of the pituitary gland or adrenal glands, in which the level of adrenal hormones - glucocorticoids - is increased in the blood.

Leukocytosis - an increase in the number of leukocytes in the peripheral blood over 9.0x109/l.
The causes of leukocytosis are divided into several groups:
infections (including septicemia);
aseptic tissue necrosis;
systemic connective tissue diseases;
reactive leukocytosis that occurs in response to metastatic
bone marrow damage;
physiological leukocytosis.
Most often, leukocytosis is caused by bacterial infections of various types. A particularly pronounced increase in the number of leukocytes occurs with suppuration of wounds and abscesses of organs. Leukocytosis can be a manifestation of an independent neoplastic disease - leukemia. Systemic diseases can be accompanied by leukocytosis, especially often rheumatoid arthritis, dermatomyositis, periarteritis nodosa. Leukocytosis against the background of aseptic necrosis is observed with infarctions of organs: myocardium, kidney, spleen, with aseptic necrosis of the femoral head, etc.
Physiological leukocytosis is known, which can be observed in individuals after eating, fright, against the background of pain and various stressful situations.
Neutrophilic leukocytosis is characteristic of acute infectious processes, inflammation occurring with tissue necrosis (acute appendicitis, pneumonia, myocardial infarction), lead poisoning, and may also be a consequence of the use of certain medications (for example, glucocorticoids).
In severe infectious diseases, myelocytes may appear in the neutrophil formula, and signs of degeneration in the form of hypersegmented nuclei, vacuolated cytoplasm, toxigenic granulation, etc. can appear in mature granulocytes.
The leading reserve of mature granulocytes in the body is considered to be the bone marrow granulocyte reserve. Using the radioisotope method, it was found that a rapid increase in the number of granulocytes due to the mobilization of the bone marrow reserve into the peripheral blood during pathological processes begins on the 5th day, often accompanied by a band shift in the leukocyte formula.
The increased release of leukocytes from the bone marrow storage is associated with the action of colony-stimulating factors (CSF), primarily granulocyte CSF (G-CSF) - a stimulator of growth and maturation of granulocyte leukocytes and granulocyte-macrophage CSF (GM-CSF) - an activator of growth and maturation of granulocytes and monocytes and macrophages.
High neutrophilic leukocytosis with a pronounced shift of the formula to the left up to promyelocytes can occur in acute bacterial pneumonia, acute hemolysis of erythrocytes, malignant tumors with multiple metastases to the bone marrow.
The total number of leukocytes in the blood volume can increase to significant figures, which, in combination with a sharp rejuvenation of the neutrophil formula, resembles the blood picture in chronic myeloid leukemia. This similarity with leukemia served as the basis for calling this blood reaction the leukemoid reaction of the myeloid type.
Unlike leukemia, in which the hematopoietic tissue is primarily affected, the leukemoid reaction is temporary, symptomatic: it disappears after the cause that caused it is eliminated.
The presence of granulocytes in circulation is not their main purpose. Neutrophils perform their main function, phagocytic, in tissues where they migrate through the capillary wall.
Eosinophilic leukocytosis is an increase in the total number of leukocytes in the blood volume due to eosinophils, the absolute content of which exceeds 0.3x109/n. Eosinophilia is most often observed in parasitic, allergic diseases, and in hypoproduction of glucocorticoids.
Eosinophilia observed in cancer, including leukemia, is apparently due to increased production of IL-3 under the influence of factors secreted by tumor tissue. There is a known cytotoxic effect caused by eosinophil peroxidase, which leads to the death of tumor cells. However, chemical factors released by tumor tissue can lead to degeneration of eosinophils (the appearance of vacuoles in the cytoplasm, a decrease in the number of granules in the cell).
Some diseases, such as histiocytosis (connective tissue diseases), are accompanied not only by an increase in eosinophils in the peripheral blood, but also by their accumulation in tissues. Biologically active substances released during degranulation of eosinophils can damage the vascular endothelium, endocardium, etc.
Monocyte leukocytosis is an increase in the total number of leukocytes in the blood volume due to monocytes, the absolute content of which exceeds 0.6x109/n. Monocytosis occurs in some diseases (smallpox, measles, rubella, infectious mumps, scarlet fever, infectious mononucleosis, acute protozoal diseases). In pulmonary tuberculosis, monocytosis accompanies the acute phase of the disease, giving way to lymphocytosis in the inactive phase of the disease. At the site of inflammation, where monocytes migrate from the bloodstream, they play the role of macrophages, participating in the neutralization of toxins and regulation of fibroblast activity.
Lymphocytic leukocytosis is an increase in the total number of leukocytes in the blood volume due to lymphocytes, the absolute content of which exceeds 3.0x109/n. Lymphocytosis accompanies chronic bacterial infections (syphilis, tuberculosis), viral diseases, and graft-versus-host disease.

The species composition and functions of leukocytes are diverse. The reaction to events occurring in the body is instantaneous. In most cases, leukocytosis is considered a protective reaction, but there are other reasons for the increase in the number of white blood cells.

The population of leukocytes (Le) is quite organized, it even seems that they almost have intelligence, since they know everything: what is happening and where, they unmistakably go to the lesions, recognize “theirs” and “theirs”, kill unwanted “guests”, which are often infectious agents. They respond to problems in the body by increasing activity and increasing content in the peripheral blood. Leukocytosis is the name of this process.

There is a strict hierarchy in their population: who is destined to command and who is destined to execute flawlessly. Precisely impeccable, because otherwise the complex structure of interactions will be disrupted and then the body will not cope. That is why, as soon as a person enters the hospital, the first thing they do is take the “two”, that is, leukocytes, since leukocytosis is an important diagnostic sign of many diseases.

Causes of leukocytosis

In order not to be frightened and to correctly assess the situation when the test is taken and a clear increase in white blood cells is observed, you need to know causes of leukocytosis, which can be very diverse:

• Any acute infectious process, even ARVI, even influenza, even, God forbid, plague or cholera will give leukocytosis, since leukocytes, being immunocompetent cells, will definitely react;
• Chronic inflammatory diseases localized in any organ also give rise to leukocytosis, although not as pronounced, since the body seems to get used to it and does not fight so actively;
• Due to the fact that white blood cells rush to places where there is a problem, damaged tissue for injuries leukocytes will definitely “call” for help;
• Leukocytosis will manifest itself and food taken, therefore it is not recommended to take it before taking the test. Digestive (food leukocytosis) occurs when leukocytes enter the circulation from the blood depot and accumulate in the submucosal layer of the intestine after a heavy meal (protective function). This is a physiological process, however, it will make a person nervous, and it can also mislead the doctor;
• With obvious manifestations allergies It is better not to take the test - leukocytes will definitely be elevated, the same applies to people with autoimmune diseases, because the body is in constant struggle;
• An increased level of white blood cells can be observed during severe pain and emotional stress, because white blood cells will not remain indifferent to pain, severe physical And psycho-emotional stress;
• Leukocytes can “sense something foreign” when entering the body of some medicinal substances in and, “deciding” that they need to fight, begin to multiply intensively;
• Leukocytosis in children is caused more often than in adults; the reasons for its occurrence are all of the above factors, but, in addition, one must take into account that the child’s body reacts faster and more often to any influences. Children love active games, run around a lot, and if they take a test immediately after physical activity, leukocytosis is guaranteed. Elevated levels of white blood cells perform a metabolic function in newborns, so a high level is also not a warning sign;
• A physiological process such as pregnancy, also leads to leukocytosis, since the woman’s body begins to prepare to protect itself and the child long before childbirth, so an increased level of white blood cells during pregnancy is a completely natural phenomenon. Leukocytosis in pregnant women usually prevents infection from entering the woman’s body during childbirth and stimulates the contractile function of the uterus;
• The leukocyte formula of a man is more stable if he is not into gluttony, does not engage in strength sports and does not particularly work hard on heavy muscular work, since in them these factors under physiological conditions constitute the main causes of leukocytosis. What does it have to do with myogenic, causing an increase in white cells by 3-5 times, leukocytosis can be both redistributive and true due to increased leukopoiesis;
• Disturbance of leukopoiesis in the bone marrow, not associated with physiological effects, is the worst reason for an increase in the number of white cells, because then we will no longer be talking about the body’s reaction, but about a specific disease.

In connection with the above, there are types of leukocytosis, which formed the basis for its classification.

Classification and characteristics of white blood cells

Approximately half a century ago, the lower limit of normal leukocytes fluctuated between 5.5-6.0 G/l; currently this level has dropped to 4.0 G/l, or even less. This is due to widespread urbanization, increased radioactive background, and the use of a large number of medications, sometimes unjustified. However, leukocytosis has not disappeared anywhere and, under certain circumstances, makes itself felt as a symptom of some disease, since it is not an independent nosological unit.

The following types of leukocytosis are distinguished:

1. Physiological ( redistributive or, as they used to call it, relative), caused by the redistribution of an increased number of white blood cells between the vessels of various organs;
2. Pathological (reactive or absolute), associated with a violation of leukopoiesis in the pathology of the hematopoietic organs or arising as a response of the body to infectious, purulent-inflammatory, septic and allergic processes.

The classification of leukocytes and leukocytosis is based on the types of white blood cells, their functions and behavior. White blood cells, depending on the presence or absence of specific granules in the cytoplasm, are divided into two rows: granulocytic And agranulocytic.

What kind of cells are these - leukocytes? Why do they behave this way and why do they care? What do the terms “ neutrophilic and eosinophilic leukocytosis” that doctors often mention? Why is leukocytosis dangerous or is it not dangerous at all?

And you can understand this if you know the basic properties of leukocytes.

Basic properties of leukocytes, their tasks and functions

The size of leukocytes, depending on the type, ranges from 7.5 to 20 microns; they contain many enzymes (peptidases, lipases, diastases, proteases), which in a quiet state are isolated (in lysosomes) and are called lysosomal enzymes. Leukocytes perform their functions outside the vessels, and they use the vascular bed only as a road. They are characterized by an amoeboid movement, with the help of which they penetrate the endothelium of the capillaries ( diapedesis) and are directed to the lesion ( positive chemotaxis). The reverse movement of leukocytes from the source of irritation is called negative chemotaxis.

If we talk about the norm of leukocytes, then the range of variation here is quite wide (4.0-9.0 G/l) Moreover, blood taken from a finger contains information about only a sixth of white cells, because their main habitat is tissue. And in order to understand where is the norm and where is the pathology, of course, you need to know what the population of leukocytes is, what tasks it performs, what they are needed for and whether it is worth worrying at all if suddenly a large content of white cells is detected.

The lifespan of leukocytes depends on the type and ranges from several days to 20 years or more. Those leukocytes that have turned into “memory cells” are destined to live long, since even after a long period of time they are obliged to recognize the “foreign” that they met many years ago. Having “remembered” it, they must immediately “inform interested” species. They, in turn, must “give the command” to destroy the stranger.

The main tasks of white blood cells can be represented as follows:

• Leukocytes take part in the formation of cellular and humoral immunity, which makes them protective function;
• They enter the gastrointestinal tract, capture nutrients and transport them into the blood, which is especially important for newborns who, while breastfed, receive ready-made, unchanged maternal immunoglobulins along with milk, which can protect a small person from many infections. That is why a child under one year old is not afraid of, for example, the flu. Nature has thought of everything, giving leukocytes metabolic function;
• Dissolve (lyse - lysis) damaged tissues and carry out histolytic task;
• They destroy various bookmarks that are not needed at all, even in the embryonic period - morphogenetic function.

A detailed blood test involves counting not only the total number of leukocytes, but also the percentage of all types of white blood cells in the smear. By the way, the percentage ratio must be converted into absolute values ​​( leukocyte profile), then the information content of the analysis will increase significantly.

Granulocyte series

The progenitors of leukocytes (myeloblasts), belonging to the granulocytic series, originate in the bone marrow, where they pass through several stages and do not enter the bloodstream until the end of maturation. In the peripheral blood, under some pathological conditions (or purely by chance - 1 cell), metamyelocytes can be found. These are young (juvenile) cells, they are also the precursors of granulocytes. However, if for some reason young ones appear in the blood, and at the same time they can not only be seen, but counted in a smear, then it is possible to judge shift left(for leukemia, infectious and inflammatory diseases). An increase in the smear of old forms indicates shift formula to the right.

formation of blood cells from stem cells in the bone marrow

Cells of the granulocyte series are endowed with pronounced enzymatic and metabolic functions, therefore their characteristic neutrophilic, eosinophilic and basophilic granularity is closely related to the activity of the cell and for each type it strictly specific, i.e., cannot transform from one type to another.

Representatives of granulocytes

Uncontrolled malignant proliferation (reproduction) is called (not to be confused with leukocytosis). In this disease, leukocytes cease to perform their function, since they could not differentiate due to a failure in hematopoiesis. Thus, leukemia is dangerous not so much due to the increased growth in the number of white cells, but rather due to their lack of skills to perform their functions. Treatment of leukemia is a difficult task for hematologists, which, unfortunately, is not always solved successfully. It depends on the form of leukemia.

Many people believe that white blood cells exist to indicate the presence or absence of inflammation, but meanwhile, the scope of activity of white blood cells is very wide. If leukocytes (in particular, T cells) were not affected by HIV infection, we would probably be able to defeat AIDS.

Leukocytosis is an increase in the number of leukocytes in the blood to more than 8000-9000 per 1 mm3; hyperleukocytosis - more than 1 mm 3. Leukocytosis occurs as a result of increased leukopoiesis or from the redistribution of leukocytes in the body.

There are physiological and pathological leukocytosis. Physiological leukocytosis includes digestive (occurring after eating), muscular (after physical stress), leukocytosis of newborns, pregnant women and leukocytosis from cooling. Pathological leukocytosis occurs as a reaction of the hematopoietic organs to irritation caused by infectious, toxic, purulent-inflammatory, radiation and other agents. Leukocytosis is also observed during tissue necrosis (myocardial infarction, tumor disintegration), after large blood losses, injuries, brain injuries, etc. Leukocytosis, as a rule, is a transient phenomenon, it disappears along with the cause that caused it. Temporary leukocytosis with the appearance of immature forms in the blood is designated as leukemoid reaction (see), a persistent similar blood picture is observed in leukemia (see). In most cases of leukocytosis, an increase in the number of neutrophils occurs - neutrophilic leukocytosis, often with a shift to the left (see Leukocyte formula). Eosinophilic leukocytosis (see Eosinophilia) accompanies many allergic conditions (bronchial asthma, serum sickness), helminthic infestations, itchy dermatoses, etc. Lymphocytosis (see Lymphocytes) is observed in some infections and intoxications. Monocytosis is observed in septic endocarditis, malaria, rubella, mumps, syphilis, etc.

Leukocytosis is an increase in the total number (or individual forms) of leukocytes in the peripheral blood under physiological conditions and pathological processes.

Leukocytosis is temporary and disappears along with the cause that caused it. The normal number of leukocytes in the blood is 6000-8000 per 1 mm 3 with extreme fluctuations from 4000 to 9000 per 1 mm 3. In healthy people, the number of leukocytes is not constant during the day; it fluctuates within the physiological norm. In addition, the average error in white blood cell counts is 7%. An increase in the number of leukocytes to or above is called hyperleukocytosis. Leukocytes are normally distributed unevenly in the bloodstream of various organs and systems. Their content was found to be significantly higher in the liver, spleen, and also in the central vessels compared to the vessels of the skin. Leukocytosis can occur as a result of redistribution of leukocytes in various vascular areas, their mobilization from the depot (redistribution, or neurohumoral, leukocytosis), with irritation of the bone marrow by pathological agents, increased leukopoiesis with the appearance of young forms of leukocytes in the blood (absolute, or true, leukocytosis). Both true and redistributive leukocytosis can be observed simultaneously. The tone of blood vessels is important: their expansion and slowdown of blood flow is accompanied by an accumulation of leukocytes, while narrowing is accompanied by a decrease in their number. There are physiological and pathological leukocytosis.

Physiological leukocytosis, mostly redistributive, transient, is observed during pregnancy (especially in the later stages), during childbirth and in newborns, with muscle tension (in athletes, in children after crying) - myogenic leukocytosis; with a rapid transition from a vertical to a horizontal position - static leukocytosis; after a cold shower or bath. Digestive leukocytosis occurs 2-3 hours after eating food, especially protein; it is often preceded by leukopenia. In the development of this type of leukocytosis, conditioned reflex reactions are important: leukocytosis can be observed at the mention of food, at the time of the usual meal. Mental excitement can lead to leukocytosis.

Pathological leukocytosis is observed in many infectious diseases, inflammatory processes, especially purulent, toxic effects, under the influence of ionizing radiation (very short-term), with skull injuries, concussions, cerebral hemorrhages, after operations, with shock (traumatic leukocytosis). This includes toxic leukocytosis observed in case of poisoning (arsenic, mercury, carbon monoxide, acids), tissue decay, necrosis due to impaired local circulation (gangrene of the extremities, infarction of internal organs, malignant neoplasms with decay), as well as uremic, drug-induced leukocytosis (when taking collargol, antipyrine), adrenaline (irritation of the sympathetic nerve). Posthemorrhagic leukocytosis occurs after heavy hemorrhages (irritation of the bone marrow by blood breakdown products). High degrees of leukocytosis with significant rejuvenation of leukocytes occur in leukemoid reactions, especially in leukemia. In some diseases (appendicitis, lobar pneumonia, angina), an increase in the number of leukocytes in the blood taken from the skin over the affected organ is noted - local leukocytosis.

Pathological leukocytosis is most often neutrophilic (neutrophilia) and is often accompanied by qualitative changes in neutrophils (“nuclear shift”). The severity of leukocytosis during infection depends on its severity, nature and reactivity of the body. In young people, the reaction of hematopoietic tissue is more pronounced; in old people it is often absent. In addition to neutrophilic leukocytosis, leukocytosis is distinguished, depending on an increase in the number of other types of leukocytes.

Eosinophilic leukocytosis (eosinophilia) often occurs without an increase in the total number of leukocytes. Eosinophilia is observed in allergic conditions (bronchial asthma, Quincke's edema, intolerance to drugs, such as penicillin, etc.), helminthiasis (ascariasis, echinococcosis, trichinosis), as well as scarlet fever, periarteritis nodosa, hemorrhagic vasculitis, rheumatism, syphilis, tuberculosis, lymphogranulomatosis. The appearance of eosinophilia in acute infectious diseases during the period of subsidence of fever is regarded as a favorable prognostic sign.

Basophilic leukocytosis is rarely observed, for example, with the injection of a foreign protein (vaccinations), hemophilia, hemolytic anemia, leukemia.

The noted types of leukocytosis, occurring with an increase in granulocytes, can be considered as granulocytosis. An increase in blood lymphocytes (lymphocytosis) and monocytes (monocytosis) may also be observed. Monocytosis is observed in infections (typhoid fever, malaria, smallpox, measles, mumps, syphilis), protozoal diseases, prolonged septic endocarditis, and chroniosepsis.

Pathological leukocytosis has a certain diagnostic and prognostic significance, in particular for the differential diagnosis of a number of infectious diseases and various inflammatory processes, assessment of the severity of the disease, the reactivity of the body, and the effectiveness of therapy. In this case, one should take into account the increase in the number of leukocytes of certain types, the qualitative characteristics of neutrophils (“nuclear shift”) and the clinical picture of the disease as a whole.

LEUKOCYTOSIS

Leukocytosis is an increased number of leukocytes in the peripheral blood (usually more than 10 billion/l).

There are three pathogenetic mechanisms for the development of leukocytosis:

1. blood thickening;
2. redistribution of leukocytes in the vascular bed;
3. release of leukocytes from the bone marrow into the peripheral blood.

Leukocytosis can be pathological and physiological. Pathological leukocytosis occurs in painful conditions, physiological leukocytosis can occur in healthy people.

Physiological leukocytosis can be triggered by several reasons:

• food intake (the number of leukocytes in this case does not exceed 10-12×10 9 /l);
• physical work (myogenic leukocytosis);
• transition from a vertical to a horizontal position (orthostatic leukocytosis);
• taking hot and cold baths;
• premenstrual period;
• pregnancy, childbirth.

The causes of pathological leukocytosis can be:

• inflammatory diseases caused by microorganisms (peritonitis, phlegmon, etc.);
• inflammatory diseases of non-microbial origin (for example, systemic lupus erythematosus, rheumatoid arthritis);
• infectious diseases that mainly affect cells of the immune system (infectious lymphocytosis and infectious mononucleosis);
• infectious diseases (pyelonephritis, sepsis, pneumonia, meningitis, etc.);
• organ infarctions (myocardium, lungs);
• proliferative diseases of the blood system, in particular leukemic and subleukemic forms;
• large blood loss;
• splenectomy;
• uremia, diabetic coma;
• malignant diseases.

There are several main forms of pathological leukocytosis:

Basophilic leukocytosis is caused by an increase in basophil production, observed during pregnancy, ulcerative colitis, myxedema, and allergic reactions. In these cases, an increase in the number of basophils does not lead to an increase in the number of leukocytes. An increase in basophils is an unfavorable prognostic sign in chronic myeloid leukemia.

Eosinophilic leukocytosis is caused by accelerated production of leukocytes and their release from the bone marrow into the blood. The main cause of this leukocytosis is immediate allergic reactions.

Neutrophilic leukocytosis in most cases is caused by an increase in the production of leukocytes and their release from the bone marrow into the blood. In this case, absolute neutrophilic leukocytosis is noted. If the majority of leukocytes move from the marginal pool to the circulating pool, relative neutrophilic leukocytosis is observed.

Lymphocytic leukocytosis (lymphocytosis) is characteristic of some acute and chronic infections, infectious mononucleosis. Infectious lymphocytosis occurs with an increase in the absolute number of lymphocytes in the blood, this is associated with an increase in the flow of lymphocytes into the blood from the organs of lymphocytopoiesis.

Monocytic leukocytosis (monocytosis) is observed in bacterial infections, diffuse connective tissue diseases, diseases caused by rickettsia, malignant neoplasms, and sarcoidosis. In chronic myelomonocytic and monocytic leukemia, a stable increase in the number of monocytes in the blood is observed. Absolute monocytosis occurs in patients with infectious mononucleosis or agranulocytosis in the phase of beginning recovery.

Leukocytosis

Leukocytosis is a condition characterized by an excess of white blood cells (leukocytes) in the blood. They are produced in the bone marrow and are part of the human immune system, protecting us from the invasion of “enemies” and preventing the proliferation of pathological cells. The number of leukocytes in the blood is not a constant value; it increases with emotional or physical stress, sudden changes in ambient temperature, intake of protein foods, and also with diseases. In the case of disease, leukocytosis is pathological, while an increase in the number of leukocytes in a healthy person is physiological leukocytosis. A significant increase (up to several hundred thousand) in the number of leukocytes usually indicates a serious blood disease - leukemia, and an increase to several tens of thousands indicates an inflammatory process.

Leukocytosis - what is it?

Leukocytes are blood cells that support immunity in the body. They are not homogeneous; there are several varieties of them that perform specific functions:

• Neutrophils - destroy bacteria using phagocytosis, “devouring” the bacterial cell.
• Monocytes - actively move from the blood to the site of inflammation, where they utilize large foreign particles.
• Lymphocytes are responsible for the destruction of viruses that enter the body and antitumor immunity.
• Eosinophils and basophils are involved in allergic reactions.

Normally, the number of these cells varies - from 4 to 9 x 109 per liter of blood. Accordingly, leukocytosis is an increase in their number above normal. The quantitative severity depends on its causes and the physiological state of the body.

Types of leukocytosis

Leukocytosis can be true or absolute (with an increase in leukocytes or the mobilization of their reserves from the bone marrow), as well as redistributive or relative (an increase in the number of leukocytes as a result of blood thickening or their redistribution in the vessels).

The following types of leukocytosis are also distinguished:

1. Physiological leukocytosis: observed after heavy physical exertion, eating protein foods, etc.;
2. Pathological symptomatic leukocytosis: occurs in certain infectious diseases, purulent-inflammatory processes, as well as as a result of a certain reaction of the bone marrow to tissue breakdown, which was caused by a toxic effect or circulatory disorder;
3. Short-term leukocytosis: occurs as a result of a sudden “release” of leukocytes into the blood, for example, during stress or hypothermia. In such cases, the disease is reactive in nature, i.e. disappears along with the cause of its occurrence;
4. Neurophilic leukocytosis is most often caused by an increase in the formation and release of neutrophils into the blood, while an increase in the absolute number of leukocytes is noted in the vascular bed. Observed in acute infection, chronic inflammation, as well as myeloproliferative diseases (blood diseases);
5. Eosinophilic leukocytosis develops as a result of accelerated formation or release of eosinophils into the blood. The main causes are allergic reactions, including to foods and medications;
6. Basophilic leukocytosis is caused by an increase in the formation of basophils. Observed during pregnancy, nonspecific ulcerative colitis, myxedema;
7. Lymphocytic leukocytosis is characterized by an increase in lymphocytes in the blood. Observed in chronic infections (brucellosis, syphilis, tuberculosis, viral hepatitis) and some acute infections (whooping cough);
8. Monocytic leukocytosis is extremely rare. It is observed in malignant tumors, sarcoidosis, and some bacterial infections.

Causes of leukocytosis

This condition in most cases is the body’s reaction to factors that can change the constancy of the internal environment (homeostasis). Conventionally, they can be divided into physiological, pathological factors and blood diseases themselves.

Physiological factors

The impact of this group of causes is not a manifestation of the disease; the number of cells increases temporarily and returns to normal on its own. These include:

1. Eating leads to a slight increase in leukocytes up to 109 per liter of blood, their return to normal occurs within a few hours. Therefore, it is recommended to donate blood for clinical analysis on an empty stomach.
2. Physical activity – during muscular work, lactic acid accumulates in the body, causing an increase in white blood cells.
3. Exposure to high or low temperatures.
4. Stress, nervous tension.
5. Leukocytosis during pregnancy is associated with changes in a woman’s hormonal levels in the second trimester of pregnancy. To exclude pathology, additional studies are carried out.
6. Physiological leukocytosis in newborns - after the birth of a child, this is necessary for the baby to meet the external environment, for its additional protection from aggressive factors and infections.

Pathological factors

This group of causes leads to persistent leukocytosis; its return to normal does not occur on its own, but only after appropriate treatment aimed at eliminating the causative factors, namely:

• Bacterial infection - all pathogenic bacteria, entering the body, cause an inflammatory reaction and leukocytosis due to neutrophils.
• Viral infection - lymphocytes increase, which destroy cells affected by the virus.
• Allergic reactions - when an allergen enters the body, eosinophils and basophils are activated, they secrete specific substances responsible for the manifestations of allergies.
• Infarctions of various organs are the death of organ cells due to acute disruption of blood circulation in it, leading to aseptic (non-bacterial) inflammation. In this case, monocytes and neutrophils utilize dead cells.
• Extensive burns - neutrophils and monocytes utilize dead cells of damaged tissues.
• Significant blood loss - the number of all blood cells increases due to a decrease in the volume of its liquid part (plasma).
• Removal of the spleen - the spleen is responsible for the disposal of leukocytes and red blood cells, in the absence of which old cells accumulate in the blood.
• Uremia - an acute disorder of the kidneys causes an increase in the concentration of unresolved protein breakdown products, leading to intoxication (poisoning).

Blood diseases

These diseases include leukemia, which is characterized by the uncontrolled division of malignant cells in the bone marrow. Moreover, almost all leukocytes are defective, unable to perform their functions. Depending on the severity, several forms of leukemia are distinguished:

• leukemic - the number of leukocytes is 109 per liter;
• subleukemic – x 109 per liter;
• leukopenic – in this form – reduced;
• aleukemic – almost complete absence of them.

It is worth noting that the causes of leukocytosis in children are the same as in adults, but the speed and severity of the increase in the number of leukocytes is much higher. So, with the same infection, a child’s body’s reaction will be more pronounced than an adult’s.

Symptoms of leukocytosis

Leukocytosis is not an independent disease, and therefore its symptoms coincide with the signs of the diseases that caused it. In children, leukocytosis is often asymptomatic, which is why doctors recommend that parents periodically have their child’s blood tested in order to detect abnormalities in the composition of the blood at an early stage.

The most dangerous, although the rarest type of leukocytosis is leukemia, or blood cancer, and therefore it is necessary to know its symptoms so as not to miss the onset of the disease. So, with leukemia, the common symptoms of leukocytosis are as follows:

• Unreasonable malaise, weakness, fatigue;
• Increased body temperature, increased sweating at night;
• Spontaneous hemorrhages, frequent formation of bruises;
• Fainting, dizziness;
• Pain in the legs, arms and abdomen;
• Labored breathing;
• Poor appetite;
• Unexplained weight loss.

If you find yourself with two or more of the listed signs, you should consult a doctor and take a blood test.

Why is leukocytosis dangerous?

In itself, an increase in white blood cells is the body’s response to the disease. Detection through a clinical blood test requires further in-depth examination to diagnose the causes. An unclear cause and the lack of treatment are dangerous for the body, as they can lead to the development of complications and depletion of the immune system.

The main danger is the complication of the development of those diseases that caused the disease. Leukemia, malignant tumors, etc. may also develop. The condition of pregnant women with this diagnosis may worsen, leading to premature birth or the development of pathologies in the fetus. Physiological leukocytosis, as a rule, does not pose a danger and is easily corrected by the body without outside help.

Diagnostics

To identify this disease you may need:

• take a general blood test;
• take a complete blood test;
• perform a bone marrow biopsy;
• perform a lymph node biopsy;
• do a biopsy of the liver and spleen;
• give a peripheral blood smear.

The analysis should be deciphered by an experienced therapist who, based on the results, can confirm or refute the diagnosis. If alarming symptoms are observed in a child, diagnosis and examination must be done by a pediatrician. It should be remembered that treatment of leukocytosis cannot be carried out without identifying the cause that caused it!

Treatment of leukocytosis

Treatment is entirely aimed at eliminating the causes, for which various approaches are used:

• antibiotics for bacterial infections;
• antiviral drugs;
• antiallergic drugs;
• restoration of tissues and organs after burns or heart attacks;
• detoxification therapy for uremia;
• chemotherapy and bone marrow transplantation in case of leukemia;
• increase in plasma volume after bleeding.

An important stage in the treatment process is proper individual nutrition. In the case of a low level of leukocytes, the diet should be enriched with foods that stimulate the production of hemoglobin. It is best to eat foods enriched with vitamin B9, legumes, and drink milk. You should also limit your consumption of meat products, completely excluding kidneys and liver.

Prevention

• preventing the development of bacterial and infectious diseases;
• regular examinations with a therapist;
• regular testing;
• systematic increase in immunity;
• preventive examinations by specialists;
• following the principles of rational nutrition;
• maintaining a healthy daily routine;
• for pregnant women - healthy sleep at least eight hours a day and good nutrition.

An experienced therapist should treat leukocytosis in the blood. You may need the help of an infectious disease specialist, gastroenterologist, nephrologist, urologist, gynecologist, andrologist, etc.

Thrombocytopathy

Hemophilia

Polycythemia

The information on the site is provided for informational purposes only. Do not self-medicate, be sure to consult your doctor.

Causes of increased leukocytes in the blood

A clinical blood test is one of the simplest and most common tests. In addition, it is highly informative. Great importance in this study is given to counting the total number of leukocytes, as well as their individual fractions. The norm of their content in the blood ranges from 4 to 9 billion per liter. If there is an increase in their number, then this condition is called leukocytosis, if there is a decrease - leukopenia. Let us dwell in detail on the reasons why leukocytes in the blood can be elevated without affecting changes in the leukocyte formula (this is a separate big topic). Leukocytosis is a fairly common symptom, so it is very important to have an idea of ​​the factors that cause it.

Physiological leukocytosis

Often, an increase in leukocytes in the blood is due to physiological reasons and is not associated with any pathological conditions. Most often, such leukocytosis is redistributive. This means that the total content of leukocytes in the blood does not actually change, they are simply redistributed in favor of the skin vessels, from which the analysis is taken. This gives the false impression that there are more leukocytes.

A striking example of this is digestive leukocytosis associated with eating food, especially rich in proteins. It can occur immediately before eating and last for another 2-4 hours after. It is based on conditioned reflex reactions. Sometimes they may not even be associated with the food itself, but with the anticipation of the meal (for example, if a person eats at the same hours every day). It is because of this reaction of the body that patients are advised not to eat before the test.

There is also myogenic leukocytosis: an increase in the number of white blood cells in the peripheral blood after intense physical activity. It is almost constantly observed in athletes involved in elite sports, but most often in pregnant women, especially on the eve of childbirth (during this period, the woman’s muscles work more intensely than usual, because there is a significant increase in weight).

Of course, the same picture is observed directly during childbirth, because childbirth is associated with severe muscle tension. Myogenic leukocytosis immediately after birth is also observed in newborns - during the first cry (this is the earliest muscle load that the child receives), and then for another two days from the moment of birth.

An increase in white blood cell levels is often associated with a redistribution of blood flow. This is observed when the body moves too quickly from a vertical to a horizontal position (static leukocytosis), or when peripheral vessels dilate after a bath or contrast shower. In addition, a physiological increase in the number of leukocytes may be associated with their sharp release from the depot. Most often this happens in a stressful situation, when, as a result of psycho-emotional stress, a large amount of adrenaline is released into the blood, which stimulates the release of deposited leukocytes into the blood. There is also leukocytosis of postpartum women, which develops two weeks after birth, and some other rarer types of physiological leukocytosis. With each of them, the number of white blood cells in the blood does not exceed billions per liter.

Pathological leukocytosis

The most common cause of increased levels of white blood cells in the blood are infections and inflammatory diseases. Typical pathogens in response to the introduction of which leukocytosis occurs are cocci:

But with infections such as influenza, malaria, measles, typhoid fever, rubella, brucellosis, polio, on the contrary, leukopenia is observed.

An increase in the level of leukocytes in the blood during infections is due to the effect of bacterial toxins and protein breakdown products on the red bone marrow. As a result of this influence, the formation of new white blood cells is stimulated, and their number increases. However, over time, if the necessary treatment is not carried out, bone marrow reserves will begin to deplete, and leukopenia may occur, which is an extremely unfavorable sign.

The highest leukocytosis develops with pneumococcal infection, especially with lobar pneumonia. With this disease, there is an increase in leukocytes in the blood of up to billions per liter. The same high numbers are observed for sepsis, meningitis, and erysipelas. In cases of severe sepsis, white blood cell levels can reach 100 billion per liter or even higher. In less pronounced inflammatory processes (pleurisy, pericarditis, etc.) of streptococcal or staphylococcal etiology, the number of leukocytes increases within the billions per liter of blood.

An increase in the level of leukocytes is an important diagnostic sign in identifying purulent processes. For example, with purulent appendicitis, the patient’s temperature does not always rise, and it is leukocytosis that indicates an intense inflammatory process, on the basis of which the doctor decides to perform an operation. The number of leukocytes during purulent processes reaches billions per liter of blood.

Another cause of leukocytosis is acute blood loss (from wounds, internal bleeding, gynecological bleeding, etc.). At present, it is not fully understood why this happens. There is a theory according to which the intensive production of leukocytes is stimulated by tissue breakdown products, as well as a decrease in oxygen levels in the blood.

Tissue breakdown products are also the cause of leukocytosis in burns, myocardial infarction, and tumor destruction. It is somewhat difficult to determine the cause of an increase in the level of leukocytes in women after childbirth: their leukocytosis can be both physiological and pathological. In this case, doctors rely on additional data.

The most unfavorable causes of leukocytosis are leukemia and lymphogranulomatosis. With leukemia, systemic damage to the hematopoietic organs occurs, with lymphogranulomatosis - individual lymph nodes. Particularly large numbers of leukocytes appear in the blood during chronic leukemia. In this case, their number can reach 100 billion per liter of blood, and even higher. However, not every leukemia has leukocytosis. That is why doctors pay attention not only to the number of leukocytes, but also to the leukocyte formula.

Leukocytosis can also be caused by the influence of toxic substances: it is observed in case of poisoning with mercury, arsenic, and carbon monoxide. In addition, the number of leukocytes in the blood may increase after taking certain medications: analgesics, glucocorticosteroids, antipyretics, silver preparations, etc. Drug-induced leukocytosis should be considered normal, but it cannot be classified as physiological, since it is not caused by natural causes, but by the influence of drugs.

There are many reasons that can lead to leukocytosis, ranging from physiological ones, such as eating or childbirth, to pathological ones, such as infection, injury, or even leukemia. Only a doctor can determine why exactly the leukocytes are elevated and what the reason was. After a clinical blood test, he will prescribe the necessary additional examinations, make a diagnosis and, if necessary, select appropriate treatment.

Leukocytosis physiological

Leukocytosis. Classification, general characteristics. Leukocytosis is a secondary symptomatic increase in the number of leukocytes in the peripheral blood, more than 1 µl, and with a constantly low initial level of leukocytes (3,000–5,000 in 1 µl) – more than 8,000–9,000 in 1 µl.

Classification of leukocytosis. In accordance with the shift in the leukocyte formula, the following types of leukocytosis are distinguished:

1) neutrophilic leukocytosis,

2) eosinophilic leukocytosis,

3) basophilic leukocytosis,

4) eosinophilic - basophilic leukocytosis,

5) neutrophilic-eosinopenic leukocytosis,

6) neutrophilic - eosinophilic leukocytosis,

9) lymphocytic - neutropenic,

10) monocyte-lymphocytic leukocytosis.

An increase in the content of leukocytes in peripheral blood can be physiological and pathological.

Physiological leukocytosis occurs in a healthy body, as a rule, is of a redistributive nature and, accordingly, is not associated with increased bone marrow hematopoiesis.

The following types of physiological leukocytosis are distinguished:

a) leukocytosis of newborns. At the birth of a child, the number of leukocytes is 9,000 per 1 µl, and a week after birth the leukocyte count fluctuates between 1 µl. However, in some cases, 6 and even 13 years after birth, leukocytosis is observed;

b) digestive leukocytosis, which develops 2–3 hours after eating;

c) myogenic leukocytosis;

d) leukocytosis during emotional stress;

e) leukocytosis during the transition from a horizontal to a vertical position (orthostatic leukocytosis).

Leukocytosis, which occurs in the second half of pregnancy, is also classified as physiological. Both redistribution mechanisms and intensification of leukopoiesis processes are involved in its development.

In some cases, redistributive leukocytosis may occur after the administration of drugs (adrenergic agonists). However, with long-term administration of adrenomimetic drugs, leukocytosis can be caused not only by the redistribution of leukocytes, but also by increased bone marrow hematopoiesis.

Regarding the features of the hematological picture in redistributive leukocytosis, it should be noted that it is short-lived, the rapid normalization of the leukocyte content in the blood after eliminating the effect of the etiological factor, as well as the normal ratio of leukocytes in the leukocyte formula.

In contrast to physiological leukocytosis, pathological leukocytosis is of a secondary symptomatic nature and develops in various forms of pathology of infectious and non-infectious nature.

Pathological leukocytosis is based on activation of myelopoiesis and increased release of leukocytes from the bone marrow into the systemic circulation. Hyperplasia of myeloid or lymphoid tissue can occur under the influence of toxic and enzymatic factors of a bacterial nature, tissue breakdown products, as well as blood leukocytes, hormonal and humoral stimulants of a non-hormonal nature.

As is known, the most significant regulators of leukopoiesis are colony-stimulating factors (CSF), acting not only at the level of committed progenitor cells, but also stimulating the processes of proliferation and maturation of morphologically identified granulomonocytic cells of the bone marrow. In this regard, it is obvious that under pathological conditions the production of CSF increases, facilitating the release of neutrophilic leukocytes into the blood from the bone marrow, as well as stimulating the processes of maturation and proliferation of elements of the granulomonocytic series.

In the mechanisms of development of true leukocytosis associated with hyperplasia of myeloid tissue, an important role should be played by changes in hormonal balance characteristic of various diseases of an infectious and non-infectious nature.

As is known, the most important adaptation hormones, intensively produced under conditions of stress stimuli (pathogenic factors), are adrenocorticotropic hormone, glucocorticoids, and catecholamines. The latter stimulate the processes of myelopoiesis indirectly by increasing the production of CSF by cells of the monocyte-macrophage and lymphoid system.

Changes regarding the qualitative and quantitative composition of leukocytes often reflect the nature of the infectious agent, the extent of the inflammatory process, and the body’s response to the corresponding etiological factor, therefore, identifying the nature of leukocytosis can have not only diagnostic, but also prognostic significance.

Leukocytosis is more often observed in acutely developing infections and much less often in chronic diseases.

Hematological characteristics of certain types of leukocytosis. Neutrophilic leukocytosis occurs with bacterial infections and intoxications of a generalized or predominantly local nature, more often with infections that cause the development of purulent inflammation (streptococcal, staphylococcal, meningococcal). However, neutrophilic leukocytosis can occur as a result of blood loss, acute hemolysis, in persons with malignant neoplasms, during hypoxia, and during intoxication of endogenous origin. Pathological neutrophilic leukocytosis, as a rule, is caused by an increase in myelopoiesis, as well as an increase in the release of neutrophils into the blood from the bone marrow granulocyte reserve.

The most important stimulators of granulocytopoiesis are colony-stimulating factors produced by monocyte-macrophage elements. Inhibitors of the mitotic activity of leukocyte cells are kelons - waste products of mature neutrophils, as well as lactoferrin, prostaglandins E, synthesized by macrophages. Thus, the intensity of granulocytopoiesis is regulated by colony-stimulating factors and a complex of inhibitors produced by virtually the same cells, according to the feedback principle. Violation of this relationship under pathological conditions leads to intensification of granulocytopoiesis.

As mentioned above, the development of neutrophilic leukocytosis is possible under various stress conditions, accompanied by the development of hypoxia, painful trauma, and exposure to emotogenic factors. Naturally, the leukocytosis that occurs under such conditions can be of a redistributive nature and occur under the influence of adaptation hormones.

To assess the severity of neutrophilic leukocytosis, the so-called nuclear index of neutrophil shift to the left is used, which is the ratio of the sum of all non-segmented neutrophils to the number of segmented cells. Normally, the shift index value is 0.06–0.08. With a favorable course of the disease, a so-called regenerative shift is noted, in which the shift index does not exceed 0.25–0.45. At the same time, band leukocytes and metamyelocytes appear in excess quantities in the peripheral blood. A hyperregenerative nuclear shift index is observed in severe infectious and purulent-septic processes; its value increases to 1.0–2.0.

In this case, leukocytosis often takes on the character of a leukemoid reaction, when the number of leukocytes increases to 1 μl, and in the peripheral blood not only the content of band and young cells, but also myelocytes increases.

The appearance of myeloblasts in the blood against the background of a high level of leukocytes should be considered a sign of a leukemoid reaction or, more often, leukemia.

Quantitative changes in peripheral blood neutrophils under pathological conditions are often combined with their qualitative changes. Thus, during purulent-septic processes, in particular with peritonitis, phlegmon, toxigenic granulation is found in the cytoplasm of neutrophils - intensely stained grains as a result of coagulation of cytoplasmic proteins under the influence of infectious-toxic factors.

Other degenerative features of neutrophils include anisocytosis, pyknosis and swelling of the nuclei, vacuolation of the cytoplasm, or shrinkage of the entire cell.

Eosinophilic leukocytosis is characterized by an increase in the number of eosinophils in the peripheral blood by more than 5% and accompanies a variety of diseases, but very often it is one of the manifestations of allergization of the body. Thus, eosinophilia is typical for atopic (anaphylactic) reactions, in particular bronchial asthma, hay fever, allergic dermatitis, drug reactions, angioedema.

Eosinophilia in allergic diseases is protective and adaptive in nature, since a characteristic feature of eosinophils is the ability to adsorb and inactivate excessive concentrations of histamine that accumulate in the pathochemical phase of allergic reactions in the extracellular environment.

The mechanisms of development of eosinophilia in allergic diseases remain unclear. However, it is necessary to take into account the fact that the state of sensitization often occurs against the background of an altered hormonal balance, in particular with insufficient levels of ACTH and glucocorticoids, and as is known, these hormones have the ability to enhance the processes of lysis of eosinophils and their migration from the systemic circulation into tissues. In this regard, it is obvious that eosinophilic leukocytosis also occurs as one of the manifestations of adrenal insufficiency.

Eosinophilic leukocytosis is characteristic of a number of autoimmune and malignant diseases, in particular chronic myeloid leukemia and lymphogranulomatosis. In myeloproliferative diseases, an increase in the number of eosinophils in the blood is due to increased eosinophilopoiesis due to tumor transformation of bone marrow cells.

In some cases, eosinophilic leukocytosis is observed in premature infants and full-term newborns in the first 3 months of life.

Basophilic leukocytosis is extremely rare and, due to the low content of basophils in the peripheral blood (0.5–1.0%), does not significantly affect the total content of leukocytes per unit volume of blood.

An increase in the number of basophils can occur with myxedema, nonspecific ulcerative colitis, and allergic reactions. However, in some cases, basophilia is one of the ominous symptoms of the development of tumor transformation of cells and myeloproliferative processes in the bone marrow. Basophilic leukocytosis occurs with erythremia, and in combination with hypereosinophilia in chronic myeloid leukemia. An increase in the number of basophils in peripheral blood in leukemia is an unfavorable prognostic sign, indicating the possibility of developing a terminal stage of pathology.

Lymphocytic leukocytosis is characterized by an increase in the content of lymphocytes in the peripheral blood over 35%. Lymphocytosis, like other types of leukocytosis, can be absolute and relative. Absolute lymphocytosis is caused by increased lymphopoiesis, an increase in the number of lymphocytes in the leukocyte formula against the background of an increased content of leukocytes in the peripheral blood. Relative lymphocytosis is observed, as a rule, against the background of a general decrease in the number of leukocytes in the peripheral blood and a predominance of lymphocytes, although the absolute content of lymphocytes remains unchanged.

Absolute lymphocytosis is a sign of some acute and chronic infections (whooping cough, viral hepatitis, infectious mononucleosis, tuberculosis, syphilis, brucellosis). In some cases, lymphocytosis is a symptom of malignant diseases - acute and chronic lymphocytic leukemia, lymphosarcoma, as well as endocrinopathies - thyrotoxicosis, adrenal insufficiency.

Relative lymphocytosis occurs as a consequence of inhibition of bone marrow hematopoiesis, in particular granulocytopoiesis, under the influence of bacterial, toxic, viral, immunoallergic factors, drugs, exposure to ionizing radiation and X-ray irradiation on the bone marrow. Relative lymphocytosis in combination with neutropenia can occur with a deficiency of folic acid and vitamin B12, when bone marrow hematopoiesis is suppressed.

Monocytosis - an increase in the number of monocytes in the peripheral blood over 8% - occurs as a manifestation of stimulation of monocytopoiesis under the influence of colony-stimulating factors produced by the monocyte-macrophage system; observed in bacterial diseases (tuberculosis, brucellosis, subacute septic endocarditis), as well as in mononucleosis, sarcoidosis, collagenosis, breast and ovarian cancer in the phase of beginning recovery in persons with agranulocytosis.

Bibliographic link

URL: http://expeducation.ru/ru/article/view?id=7791 (date of access: 03/15/2018).

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Leukocytosis, or a condition when there are a lot of leukocytes in the blood, is perhaps one of the most common abnormalities in the blood count in children and adults. This is because there are a lot of diseases accompanied by such pathology - from infectious processes to blood cancer and other very dangerous diseases. Only a doctor can understand the causes of this condition, prescribe the correct treatment and stop the development of the pathology.

Features of the disease

The biological significance of leukocytes - white blood cells that are produced in the bone marrow - is very important. They are directly involved in the formation of immunity at the cellular level. In addition, leukocytes in the blood can dissolve damaged tissues and help remove them from the body, and also enter the gastrointestinal tract, capture useful substances, and transfer them into the blood. The size of leukocytes is 7.5-20 microns; these cells contain many lysosomal enzymes. Leukocytes need vessels only for movement, and they carry out all their tasks outside the vascular bed.

The normal white blood cell count for an older child and adult is 4.0-9.0 *10*9/L. But the norm of this blood indicator in a general analysis can be exceeded, for which there are a great many reasons. Too high a count of leukocytes is observed with leukocytosis: this is what is meant by an increase in the content of these cells in a blood test. More accurate is an analysis of the leukocyte profile (leukocyte formula), which reflects the number of leukocytes of certain types. Below are the types of white blood cells and their functions in the body:

1. Neutrophils consume bacteria using phagocytosis.
2. Monocytes quickly move to the area of ​​inflammation, and there they utilize large particles that are foreign to the body.
3. Lymphocytes are responsible for eliminating viruses that have entered the blood, as well as for stimulating antitumor immunity.
4. Basophils, eosinophils - take part in allergy reactions.

Increased leukocytosis in the blood appears not only in various diseases. The classification of this condition includes two types:

1. Physiological. It occurs in healthy people, since the total number of leukocytes is an unstable value that changes with stress, physical activity, temperature changes, heavy intake of protein foods, and pregnancy.
2. Pathological. It develops in various pathological processes, both infectious and blood diseases.

Usually, a slight (moderate) leukocytosis is recognized when the number of leukocytes increases to 10-12 * 10 * 9 / l, but with a constant low initial level, this pathology is noted already when it increases to 8-9 * 10 * 9 / l. Acute, severe leukocytosis (above 20*10*9/l) is often referred to as “hyperleukocytosis”, and this condition is always accompanied by a strong shift of the leukocyte formula to the left. Seriously expressed leukocytosis (50-100 * 10*9/l. or more) usually reflects the occurrence of leukemia, a serious oncological disease.

The classification of types of leukocytosis depending on the etiology is as follows:

1. Physiological leukocytosis (always of a redistributive nature):

• in healthy newborns during the first two days of life;
• in healthy pregnant women (occurs from 5-6 months of gestation);
• in women giving birth (noted at the beginning of the second week after birth);
• myogenic (muscular);
• digestive (food or nutritional);
• emotional;
• acclimatization.

Pathological leukocytosis (has a transient nature and goes away along with the underlying disease):

• infectious (bacterial or viral);
• inflammatory;
• toxicogenic;
• posthemorrhagic;
• neoplastic (reflects the disintegration of the tumor);
• leukemic;
• unknown etiology.

There are also absolute leukocytosis - an increase in the absolute number of individual types of leukocytes, relative leukocytosis - an increase in the percentage of red blood cells when there is a decrease in other types of leukocytes.

Causes of leukocytosis in the blood

Leukocytosis itself is the body’s reaction to a disease or other abnormal condition. Finding out the exact cause of the pathology is very important, because it is not leukocytosis itself that is dangerous, but the pathology that caused it. The absence of the necessary therapeutic measures can lead to the development of dangerous consequences and to the depletion of the protective functions of the immune system.

According to pathogenesis, all leukocytoses are divided into the following groups:

1. Increased myeloplastic function of the bone marrow, which can be reactive and blastoma. This condition is called true (absolute) leukocytosis, occurs during infections, septic and purulent processes, aseptic inflammation - allergies, autoimmune diseases, frostbite, trauma, burns, myocardial infarction. This type of leukocytosis is also characteristic of intoxication with drugs or other toxic substances, occurs after irradiation, and during bleeding.
2. Redistribution of leukocytes, when their number increases due to the mobilization of cells from the depot (false or relative leukocytosis). During anaphylactic reactions, the number of white blood cells in the liver, lungs, and intestines increases, as does severe traumatic shock and severe physical overload. This phenomenon is always temporary and is not combined with an increase in the level of young leukocytes.
3. Hyperproduction of white blood cells in tumor lesions of the blood - in leukemia. An atypical increase in the total number of leukocytes is observed due to the activation of proliferation of cancer cells and more rapid division and maturation of normal leukocytes under the influence of tumor antigens.
4. Increased blood viscosity. This can occur against the background of diarrhea, vomiting, polyuria, when, with a normal total number of leukocytes and other blood cells, their concentration per unit of blood has increased.

As for the causes of physiological leukocytosis, most of them are listed above. First of all, this is nutrition, because eating causes a slight increase in white cells in the blood to 10-12 * 10 * 9/l, so a general analysis should be taken on an empty stomach. Physical activity and sports also provoke mild leukocytosis due to the accumulation of lactic acid in the body. A similar reaction of the body is observed during nervous overstrain and exposure to high and low temperatures. In infants, immediately after birth, white blood cells increase to allow the child to “meet” the environment normally, and within 48 hours they return to normal. In the second trimester of pregnancy, changes in hormonal levels also cause leukocytosis, which must be differentiated from a pathological increase in leukocytes.

With leukemia, which can occur even in an infant, only at the very beginning of the pathology there may be a low level of leukocytes, but very quickly this figure increases, and the leukocytes are defective. In general, the causes of leukocytosis in children and adults are the same, but the child’s body reacts to all pathological changes more quickly and more pronounced.

As a rule, most leukocytoses are neutrophilic, that is, they involve an increase in the number of red blood cells due to neutrophils. But sometimes leukocytosis can be basophilic, eosinophilic, lymphocytic, monocytic, mixed. Below are the main causes of one or sometimes type of leukocytosis according to changes in the leukocyte formula:

1. Neutrophilic leukocytosis (band or segmented neutrophilia). It includes all types of physiological increase in white blood cells, as well as pathological neutrophilia in all types of infections, as well as in the presence of chronic foci of bacteria, intoxication, severe hypoxia, heavy bleeding, acute hemolysis, and cancer.
2. Eosinophilic leukocytosis. Its pathophysiology is based on the release of eosinophils into the blood from the bone marrow or the acceleration of their production. Causes: immediate allergic reactions, angioedema, bronchial asthma, skin allergies, helminthiasis, periarteritis nodosa, scarlet fever, lymphogranulomatosis, myeloid leukemia. Eosinophilic leukocytosis is the earliest sign of Loeffler's syndrome.
3. Basophilic leukocytosis. A rare hematological condition, the symptoms of which may reflect the development of myxedema, severe allergies, ulcerative colitis, chronic myeloid leukemia.
4. Lymphocytic leukocytosis. Develops in acute and chronic infections - whooping cough, hepatitis, tuberculosis, syphilis, brucellosis, and infectious mononucleosis. Prolonged lymphocytosis is often a sign of lymphocytic leukemia.
5. Monocytic leukocytosis. It occurs rarely, mainly in septic endocarditis, brucellosis and tuberculosis, malaria, leishmaniasis, typhus, ovarian cancer, breast cancer in women, and diffuse connective tissue damage. Acute monocytosis is characteristic of infectious mononucleosis and agranulocytosis in the recovery stage.

Causes of leukocytosis in a smear

Smear analysis in women and men should be carried out regularly, because it will show all the changes occurring in the sexual sphere and reflect the initial and advanced stages of many diseases. For women, taking a smear is a standard procedure during any visit to the gynecologist. It is taken from the mucous membrane of the vagina or cervix. Detected leukocytes, the norm of which in a smear in women is 10-15 units in the vagina, 15-20 units on the cervix, reflect various pathological conditions:

• endometritis;
• colpitis;
• bacterial vaginosis;
• vaginal dysbiosis;
• thrush;
• cervicitis;
• adnexitis;
• urethritis;
• symptoms of sexually transmitted infections;
• oncological diseases of the genital organs.

Sometimes leukocytes in a smear in women appear against the background of severe prolonged stress, and they disappear at the end of a difficult period, or more precisely, their number returns to normal. But with chronic stress, there may even be a drop in the level of white blood cells, which reflects the depletion of local immune defenses - the last stage of the body's stress response. In any case, further research is necessary, so the woman is recommended to undergo a series of tests, colposcopy, and sometimes a biopsy.

A smear from the urogenital tract in men may also contain a high number of leukocytes. This always reflects the development of an inflammatory process, the causative agent of which can be identified through a wider examination. The inflammatory process in men can affect any organ of the genitourinary system - kidneys, bladder, prostate gland, urethra. The immediate causes of a bad smear are urethritis, prostatitis, pyelonephritis, cystitis, epididymitis, orchiepididymitis. Very often, leukocytosis reflects the presence of an STI, which can be confirmed by other symptoms - pain, pathological discharge.

Symptoms of manifestation

Since this condition is not independent, but is always a consequence of the underlying pathology, the main clinical signs coincide with those of its direct cause. Simply put, leukocytosis is only a laboratory indicator, which is more important for the doctor as a sign of trouble in the body and as a signal for urgent further examination.

In acute bacterial infections, which most often provoke leukocytosis, the following components of the clinical picture may be present:

• increase in body temperature to 37.5-39 degrees;
• feeling of weakness, fatigue, malaise;
• decreased performance;
• aching joints;
• muscle pain;
• sore throat that gets worse when swallowing;
• cough, sore throat;
• hoarseness of voice;
• secretion of sputum from the lungs;
• ear pain;
• purulent processes of various localizations, etc.

Leukocytosis is possible not only with bacterial, but also with viral infections, however, only at their very initial stage (then viruses provoke a slight decrease in the number of leukocytes). If the pathology accompanies myocardial infarction, then it is accompanied by severe, acute pain in the chest and other characteristic signs of heart disease. One of the most serious diseases in which chronic leukocytosis is observed is blood cancer, or leukemia. Its symptoms should be suspected at an early stage in order to begin treatment as early as possible. Particularly pronounced and early appearing signs of leukemia are characteristic of childhood:

• prolonged illness for no reason;
• loss of appetite;
• weight loss;
• fatigue, weakness;
• fainting and dizziness;
• low-grade fever;
• increased sweating at night;
• constant appearance of bruises and hemorrhages;
• spontaneous nosebleeds;
• enlarged lymph nodes;
• prolonged tissue bleeding after a cut or injury;
• stomach ache;
• pain in the arms and legs;
• difficulty breathing.

You should consult a doctor if you have at least 2-3 of the signs listed above. The doctor will prescribe all the necessary tests, which may help prevent the disease from reaching a severe stage. Despite the rarity of diagnosing leukemia, you cannot ignore a visit to the doctor!

Diagnostic methods

As already mentioned, leukocytosis is determined by performing a general blood test. A similar diagnosis is made if the number of white blood cells is more than 10,000 in 1 μl (10*109/l). The leukocyte count may vary depending on age, so leukocytosis may be recognized as such in different cases. Normal values ​​of leukocytes in children under one year are 6-15 units, from one to two years - 5.5-13.5 units. etc., and indicator 4 - 9 units. more typical for adults, which should be taken into account when making a diagnosis. The norms of indicators in the leukocyte formula are as follows:

1. Segmented neutrophils - 47-72%.
2. Band neutrophils - 4-6%.
3. Basophils - 0.1%.
4. Eosinophils - 0.5-5%.
5. Lymphocytes - 19-37%.
6. Monocytes - 3-11%.

If leukocytosis is detected in the blood, the doctor will prescribe a series of examinations and visits to specialists. In addition to a detailed blood test with leukoformula, a peripheral blood smear, biochemical analysis, tests for infections using ELISA and PCR methods, tests for allergens and immunoglobulins are performed, if necessary, ultrasound of internal organs, heart, chest X-ray, and if oncology or other complex diseases are suspected - biopsy of the liver, spleen, bone marrow puncture, lymph nodes. Inflammatory pathologies in the body should be differentiated from more serious diseases and allergies, the treatment of which is carried out according to a completely different scheme.

In addition to an increase in leukocytes in the blood and smears in men and women, leukocytosis can also be detected in the urine. If a person is healthy, then in the urine analysis they are absent or present in a single quantity. An increase in the level of white blood cells means the development of infectious processes in the kidneys, bladder or urethra, as well as in the genitals. To diagnose the exact cause of the pathology, a urine culture is performed to determine the presence of infection, as well as an antibiotic sensitivity test.

Treatment methods

Drug treatment

Leukocytosis can be cured only by addressing the underlying pathology that provoked it. For infectious processes, antibacterial drugs are prescribed - cephalosporins, penicillins, macrolides. It is necessary to treat an infectious disease taking into account symptomatic effects, local therapeutic measures - taking expectorants, sprays and tablets, nasal drops, anti-inflammatory drugs, etc. For allergies, a child or an adult is prescribed antihistamines, desensitizing agents, and in severe cases, corticosteroid hormones. Sometimes a person is given medications to take to reduce uric acid in the body, which will prevent the destruction of body tissues and the progression of leukocytosis.

It is strictly prohibited to take antibiotics or carry out other treatment without finding out the exact cause of the increase in leukocytes, especially when it is pronounced.

It may happen that such leukocytosis is a sign of leukemia, and its treatment differs sharply from all other treatment regimens. For blood cancers, chemotherapy and blood irradiation are used, as well as special medications - Leukeran, Filgrastim. The patient may also be recommended leukopheresis - removal of excess white blood cells from the blood and transfusion of purified blood back into the body. In this case, the blood is distilled through a special apparatus, which helps to improve its health and reduce the symptoms of the disease.

When the number of leukocytes in the blood is increased, treatment should always be done under the supervision of a doctor, especially if we are talking about a child. However, folk remedies can also improve your health. Recipes for this purpose can be as follows:

1. Take equal parts of motherwort grass, horsetail grass, and knotweed grass. All this raw material needs to be ground into powder and mixed well. You can add this powder a teaspoon three times a day to any dishes, for example, vegetable salads. If it is difficult to take the medicine in this way, then you can pour a teaspoon of powder into 100 ml of warm water, leave for half an hour, then drink before meals.
2. Collect bitter wormwood (herb), chop it well. Take three spoons of powder, pour 600 mg. boiling water, then leave this remedy for an hour. Take the infusion 15 drops three times a day before meals.
3. Prepare dry raw materials from St. John's wort herbs and flowers. 2 tablespoons of St. John's wort need to be brewed with 200 ml of boiling water, leave for 30 minutes. Divide the infusion into 3 parts, drink one hour before meals three times a day.
4. Take green beans, squeeze the juice out of them, drink a teaspoon of it in the morning on an empty stomach. This remedy will help normalize the level of leukocytes with moderate, mild leukocytosis.
5. Mix pollen with an equal amount of honey, eat 2 teaspoons of the product per day. This method is useful in detecting leukocytes in a smear in adults to increase the overall resistance of the body.
6. Brew 200 grams of lemon balm leaves in 500 ml of boiling water (we are talking about fresh leaves). Let the lemon balm brew for at least an hour, strain, and take a tablespoon three times a day. The method is suitable for any infectious and inflammatory diseases.

Homeopathy helps well with leukocytosis and the diseases that provoke it. Homeopathic medicines generally have a beneficial effect on the body, normalizing the processes occurring in it. But in case of a serious cause of pathology, it cannot be treated only with homeopathy, but can only be combined with the main therapy. However, only a specialist should select homeopathy, especially when it comes to a child.

When there is an increase in leukocytes in the blood, a diet must be applied and aimed at reducing the load on the body. You can reduce the caloric content of your diet by reducing meat in the menu, as well as by completely eliminating fatty foods. Fish and seafood are well suited for nutrition - mussels, squid, which contain a lot of B vitamins, as well as amino acids that are urgently needed by the body. The patient's daily table must include greens - asparagus, spinach, celery. Broccoli, Brussels sprouts, peas, pumpkin, beans, dairy foods and cheeses will also help relieve inflammation. Additionally, most patients are recommended to take vitamin-mineral complexes, adaptogens, and immunostimulants in order to quickly improve the functioning of the body.

Features of treatment in pregnant women

During pregnancy, as already noted, leukocytes in the blood physiologically increase. This occurs no earlier than the fifth month from the beginning of gestation, therefore, upon registration and several more times during pregnancy, the woman donates blood to monitor the level of all blood parameters. If the number of white blood cells is not higher than 20 units, then this is considered normal (in the absence of any pathological symptoms). Otherwise, the doctor will recommend further examination to find the causes of this condition.

Most often, the cause of pathological leukocytosis in the blood or urine of pregnant women is ARVI, kidney or bladder disease, allergies, acute vaginal candidiasis, severe stress, as well as any other inflammatory process of a septic or aseptic nature. If the number of leukocytes in the urine increases rapidly, the woman is hospitalized, since infections of the internal organs threaten serious consequences for her and the child.

During pregnancy, leukocytes may also increase in the smear. You cannot think that this is due to gestation and hormonal changes. In the smear, the number of these cells should remain the same as before conception, so the cause of the pathology is most often the activation of a chronic infectious process, which was in a latent state before pregnancy. All pathological conditions should be treated only under the supervision of a doctor, because inaction, as well as self-medication, can provoke a miscarriage or intrauterine infection of the fetus. A woman is recommended to have a healthy diet, a strict daily and sleep schedule, walks in the fresh air, as well as special medications - antibiotics (penicillins or cephalosporins, depending on the severity of the infection), vitamins and other medications that are not contraindicated during pregnancy.

What not to do

This condition requires the refusal of all types of heavy physical activity. Taking sick leave cannot be ignored: going to work and nervous overload during leukocytosis will only aggravate the course of the disease that caused it. It is also forbidden not to get enough sleep, to stand on your feet for a long time without rest: this way the infectious pathology will progress even faster. It is worth giving up bad habits, at least until complete recovery, so as not to further weaken your immune system.

Preventive measures

To prevent an increase in leukocytes in the blood, you should maintain your immunity level at the proper level. Only a healthy lifestyle and proper nutrition, giving up alcohol and smoking will be the key to preventing various inflammatory diseases. You should also eliminate all foci of chronic infection in the body - remove adenoids, sanitize teeth and tonsils, treat gynecological and urological diseases. During epidemics, you should protect yourself from contact with infected people, and also avoid hypothermia. If you are prone to allergies, you should avoid contact with irritants that may be present both at home and in the environment.