Neutrophilia: Causes, Symptoms and Treatment
Neutrophilia is an elevated count of neutrophils in the blood, often indicating infection, inflammation, or other medical conditions.
Things worth knowing about "Neutrophilia"
Neutrophilia is an elevated count of neutrophils in the blood, often indicating infection, inflammation, or other medical conditions.
What is Neutrophilia?
Neutrophilia (also called neutrocytosis) refers to an abnormally high number of neutrophilic granulocytes in the bloodstream. Neutrophils are the most abundant type of white blood cell and serve as the body's first line of defense against bacteria, fungi, and other pathogens. In healthy adults, neutrophil counts typically range from about 1,800 to 7,500 cells per microliter of blood. Counts above this range are classified as neutrophilia. The condition itself is not a disease but rather a marker of an underlying process in the body.
Causes
Neutrophilia is broadly categorized as either reactive (secondary) neutrophilia, which occurs in response to an external trigger, or clonal (primary) neutrophilia, which results from a disorder of the bone marrow.
Common Causes of Reactive Neutrophilia
- Bacterial infections: e.g., pneumonia, urinary tract infections, appendicitis
- Inflammatory conditions: e.g., rheumatoid arthritis, inflammatory bowel disease
- Tissue damage: e.g., after surgery, trauma, myocardial infarction, or burns
- Physical or emotional stress
- Medications: e.g., corticosteroids, G-CSF (granulocyte colony-stimulating factor), lithium
- Smoking
- Pregnancy
- Vigorous physical exercise
Causes of Clonal Neutrophilia
- Chronic myeloid leukemia (CML)
- Polycythemia vera
- Primary myelofibrosis
- Other myeloproliferative neoplasms
Symptoms
Neutrophilia itself typically does not cause specific symptoms. Any symptoms experienced by the patient are usually related to the underlying condition. Associated symptoms may include:
- Fever and chills (in cases of infection)
- Fatigue and general weakness
- Pain, depending on the underlying cause
- Enlarged lymph nodes or spleen (in hematological disorders)
- Unintentional weight loss and night sweats (in malignant conditions)
Diagnosis
Neutrophilia is identified through a complete blood count (CBC) with differential, which measures the specific proportions of each white blood cell type. To determine the underlying cause, additional tests may be ordered:
- C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) for inflammation markers
- Blood, urine, or swab cultures to detect infection
- Bone marrow biopsy if a hematological malignancy is suspected
- Molecular genetic tests (e.g., BCR-ABL testing to rule out CML)
- Imaging studies such as ultrasound or CT scan
Treatment
Treatment of neutrophilia is always directed at the underlying cause. An elevated neutrophil count alone does not require independent treatment.
- Infections: Antibiotics or antifungal medications as appropriate
- Inflammatory conditions: Anti-inflammatory drugs, including corticosteroids or immunosuppressants
- Myeloproliferative disorders: Specialized oncological therapy, e.g., tyrosine kinase inhibitors for CML
- Drug-induced neutrophilia: Adjustment or discontinuation of the causative medication under medical supervision
References
- Berliner, N. - Neutrophilia. In: Hoffman R. et al. (eds.): Hematology: Basic Principles and Practice, 7th edition, Elsevier, 2018.
- Dale, D. C. - Neutrophilia. MSD Manual, Professional Edition. Merck Sharp & Dohme, 2023. Available at: https://www.msdmanuals.com
- Palmblad, J., Nilsson, C. C., Hoglund, P., Papadaki, H. A. - How we diagnose and treat neutrophilia and neutropenia. Current Opinion in Hematology, 2012.
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