Why neutrophils are high

It is most significant when the total neutrophil count is less than 0. When the neutropenia is due to increased peripheral destruction or margination e. These patients rarely have problems with significant bacterial infection despite quite low neutrophil counts.

In routine clinical practice the most frequent cause of a low neutrophil count is overt or occult viral infection, including viral hepatitis.

Acute changes are often noted within one to two days of infection and may persist for several weeks. The neutrophil count seldom decreases enough to pose a risk of infection. A low neutrophil count is often discovered in some people as an incidental finding in the CBC result.

The patient is generally asymptomatic and the clinical examination is unremarkable. The count is usually stable on follow-up. This is likely to be idiopathic although in some cases a neutropenia may be associated with splenomegaly or an autoimmune disease such as lupus. The presentation of a haematological malignancy with only an isolated neutropenia is a rare finding.

Although relatively rare, drug therapy may cause an acquired neutropenia in some people. The drugs most likely to be associated with moderate neutropenia are chemotherapy and immunosuppressive drugs, antithyroid medications, antibiotics, antirheumatics, antipsychotics and anticonvulsants.

For a more comprehensive list see Neutropenia, drug induced. Many drugs may cause a chronic mild neutropenia e. The history and clinical features are important for providing the clues for diagnosis and allowing the results to be interpreted in context. The risk of significant bacterial infection rises as the neutrophil count drops below 1. Patients who are febrile but otherwise well should at least be discussed with a Haematologist. If the patient is well and afebrile, they need to be advised to seek medical attention promptly if their condition deteriorates or they become febrile.

Well patients should have follow up blood counts within 48 hours, and if the neutropenia persists at this level or progresses they should be discussed with a Haematologist.

If an isolated abnormality follow up blood counts are indicated, with frequency dependent on the severity of the neutropenia but usually within weeks. If the neutropenia persists for more than 6 weeks further investigation is indicated. If it is progressive or other abnormalities develop a haematology referral, or discussion with a Haematologist, is indicated. There are specific protocols for management of clozapine induced neutropenia. Otherwise, if a drug cause is suspected and the neutropenia is moderate or severe, Haematology referral, or discussion with a Haematologist is indicated.

Neutrophils are the primary white blood cells that respond to a bacterial infection. The most common cause of marked neutrophilia is a bacterial infection. Neutrophils react within an hour of tissue injury and are the hallmark of acute inflammation.

Neutrophils generally exhibit characteristic changes in response to infection. The neutrophils tend to be more immature, as they are being released earlier. This is called a left shift Figure 2. Neutrophils will frequently be increased in any acute inflammation, therefore will often be raised after a heart attack, or other infarct and necrosis.

Any stressor, from heavy exercise to cigarette smoking, can elevate the neutrophil count. A number of drugs have been demonstrated to increase the neutrophil count, including steroids, lithium, clozapine and adrenalin. Even nervousness may very slightly raise the neutrophil count because of the effect of steroid release.

Pregnancy is associated with a slight increase in total neutrophil count demonstrating a left shift. Most laboratories provide pregnancy specific reference ranges.

Persistent elevation of neutrophils may be a sign of chronic myeloid leukaemia CML. Chronic mild neutrophilia without left shift is very unlikely to be due to CML. CML occurs in all age groups but most commonly in the middle aged and elderly. The annual incidence is estimated at 1 - 2 cases per , The normal concentration of lymphocytes is between 1.

There are two broad morphologic categories of lymphocytes which can be distinguished under the light microscope, large granular lymphocytes and small lymphocytes. Steroid administration may reduce lymphocyte counts. More rarely lymphocytopenia may be caused by some types of chemotherapy or malignancies. People exposed to large doses of radiation, such as those involved with situations like Chernobyl, can have severe lymphocytopenia. Increases in the absolute lymphocyte count are usually due to acute infections, such as Epstein-Barr virus infection and viral hepatitis.

Less commonly, increased lymphocytes may be the result of pertussis and toxoplasmosis or rarely chronic intracellular bacterial infections such as tuberculosis or brucellosis. Chronic lymphocytic leukaemia CLL and other lymphoproliferative disorders should be considered in patients with a persistent lymphocytosis.

In some cases lymphocyte surface markers may be recommended for differentiating between reactive lymphocytosis and lymphoproliferative disorders. They circulate in the bloodstream for about one to three days and then typically move into tissues approx 8 - 12 hours to sites of infection.

The normal concentration of monocytes is between 0 - 1. Monocytes which migrate from the bloodstream to other tissues are called macrophages. Macrophages have a role in specific immunity and phagocytosis. Most often, elevated monocyte counts are associated with infection and inflammatory processes and will be seen in conjunction with other blood count changes. Isolated increases in the monocyte count, not accompanied by other changes in the blood count, are uncommon but may be associated with:.

If levels are persistently elevated i. Basophils are the least common of the white cells, representing about 0. The normal concentration of basophils is 0 - 0. The function of basophils is not fully understood, but it is known that they are capable of phagocytosis and producing histamine.

For the ANC test, a small amount of blood will be drawn, usually from a vein in your arm. The blood will be evaluated in a laboratory and the results will be sent to your doctor.

Certain conditions can affect the results of your blood test. Results can vary widely from lab to lab. Note that the reference ranges listed here are measured in microliters mcL , and are only approximate. Having a high percentage of neutrophils in your blood is called neutrophilia. This is a sign that your body has an infection. Neutrophilia can point to a number of underlying conditions and factors, including:. Neutropenia is the term for low neutrophil levels.

Low neutrophil counts are most often associated with medications but they also can be a sign of other factors or illness, including:. Very low neutrophil counts can lead to life-threatening infections. If your neutrophil counts are high, it can mean you have an infection or are under a lot of stress. It can also be a symptom of more serious conditions. Neutropenia, or a low neutrophil count, can last for a few weeks or it can be chronic.

Some drugs, such as corticosteroids, also lead to an increased number of neutrophils in the blood. Myeloid leukemias Chronic Myeloid Leukemia CML Chronic myeloid leukemia is a slowly progressing disease in which cells that normally would develop into neutrophils, basophils, eosinophils, and monocytes become cancerous see also Overview A high number of neutrophils may not cause symptoms.

However, people often have symptoms of the disorder that is causing the increased number of neutrophils. Very rarely, in people with leukemia Overview of Leukemia Leukemias are cancers of white blood cells or of cells that develop into white blood cells.

This condition is a medical emergency and requires hospitalization so fluids can be given by vein and drugs to reduce the white blood cell count hydroxyurea and chemotherapy drugs can be given.

Sometimes, a type of blood-filtering treatment leukapheresis Plateletpheresis platelet donation In addition to normal blood donation and transfusion, special procedures are sometimes used. In plateletpheresis, a donor gives only platelets rather than whole blood. Whole blood is drawn from Doctors often do a blood test called a complete blood count. This test may be done for many different symptoms, including signs of infection such as fever, cough, or abdominal pain , or signs of chronic illness such as weight loss or fatigue.

Cell Tissue Res. Neutrophil kinetics in health and disease. Trends Immunol. Front Immunol. Neutropenic patients and their infectious complications at a University Hospital.

Rev Bras Hematol Hemoter. Microbiol Mol Biol Rev. Gibson C, Berliner N. How we evaluate and treat neutropenia in adults. De kouchkovsky I, Abdul-hay M. Blood Cancer J. Nishitani N, Sakakibara H. Association of psychological stress response of fatigue with white blood cell count in male daytime workers.

Ind Health. Farsalinos KE, Romagna G. Chronic idiopathic neutrophilia in a smoker, relieved after smoking cessation with the use of electronic cigarette: a case report.

Clin Med Insights Case Rep. Kumar CC. Genetic abnormalities and challenges in the treatment of acute myeloid leukemia. Genes Cancer. Lustberg MB. Management of neutropenia in cancer patients. Clin Adv Hematol Oncol. Infections in myelodysplastic syndromes. Typhoid fever: "you can't hit what you can't see". Gut Microbes. Cell Rep.

Adewoyin AS, Nwogoh B. Peripheral blood film - a review. Ann Ib Postgrad Med. Medicine Baltimore. Neutrophil Function: From Mechanisms to Disease. Annual Review of Immunology.

Your Privacy Rights. To change or withdraw your consent choices for VerywellHealth. At any time, you can update your settings through the "EU Privacy" link at the bottom of any page. These choices will be signaled globally to our partners and will not affect browsing data. We and our partners process data to: Actively scan device characteristics for identification.