Major causes of leukocytosis

on 27.2.09 with 0 comments

  • Granulocytic leukocytosis (neutrophilia)

    • Bacterial infection with left shift and reactive changes, including toxic granulation, cytoplasmic vacuolization, and Dohle bodies

      • A left shift indicates that there are neutrophils in circulation that are less mature than bands

      • Toxic granulation is the appearance of coarse, purple cytoplasmic granules; this is a sign of bacterial infection

      • Cytoplasmic (toxic) vacuolization appear as holes in the cytoplasm and are very associated with bacterial sepsis

      • Dohle bodies look like little blue lakes…they are patches of dilated ER

      • If there is neutrophilia without reactive changes there is not a bacterial infection; reactive changes are very often associated with bacterial infection

    • Physiologic stress leukocytosis (NE leads to neutrophil demargination)

    • Leukemoid reaction

      • Extreme leukocytosis with immature granulocytes stimulating leukemia

      • Differential includes overwhelming infection and chronic granulocytic leukemia

    • Leukoerythroblastosis – circulating granulocyte precursors and nucleated RBCs

  • Eosinophilic leukocytosis (eosinophilia)

    • Allergic d/o (including asthma and hay fever)

    • Allergic drug reactions

    • Parasitic infections

    • Skin diseases including pemphigus, eczema, and dermatitis herpetiformis

    • Eosinophilic enteropathies including eosinophilic gastritis

    • Idiopathic hypereosinophilic syndromes including Loeffler’s

    • CA of the lung, stomach, pancreas, ovaries, or uterus

    • Collagen vascular disease (e.g., SLE)

  • Lymphocytosis

    • Chronic inflammation

    • Viral infections including hepatitis, CMV, and EBV (very common cause)

  • Monocytosis

    • Chronic infections including TB, bacterial endocarditis, brucellosis, malaria, and rickettsiosis

    • Chronic inflammation as seen with collagen vascular diseases and inflammatory bowel disease

    • Myelodysplastic syndromes

Category: Medical Subject Notes , Pathology Notes



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