Leukocytosis

Leukocytosis is a discomforting condition which affects many people across the world. Read on to find out all about the causes, symptoms, diagnosis, treatment and more about the disorder.

Leukocytosis Definition

Medical researchers define Leukocytosis as a condition characterized by an unusual rise in white blood cell quantity in the bloodstream. It is defined as the presence of over 10,000 leukocytes in every cubic millimeter of blood.

The disease is also often referred to as Leucocytosis.

Leukocytosis ICD9 Code

The ICD9 Code for Leukocytosis is 288.3.

Leukocytosis Types

The condition can be subcategorized on the basis of increase of the type of WBC (white blood cell) that is involved. The subtypes of Leukocytosis include:

• Neutrophilia – It is characterized by an increase in the number of neutrophiles (main phagocytic leukocytes).
• Lymphocytosis – It is marked by a rise in the amount of Lymphocytes (lymph cells).
• Monocytosis – It involves an elevation in the quantity of monocytes, a form of granular leukocyte that participates in bacterial ingestion.
• Eosinophilia – It leads to a rise in the number of eosinophils.

Neutrophilic Leukocytosis

Also referred to as “Neutrophilia”, the condition is characterized by the presence of an excessive amount of neutrophil granulocytes in the bloodstream. A rise in the amount of blood neutrophil may occur due to side-effects of medications, burns or heart attack. Bacterial infection is, however, the most common cause of this condition.

Digestive Leukocytosis

It refers to a rise in leukocytes (white blood cells) in blood after consumption of some types of food. This usually arises as a response to toxic or undigested foods. As the condition is always found to arise after a meal, it was earlier regarded as a normal physiological response to food consumption.

Physiological Leukocytosis

It refers to Leukocytosis which is not directly associated to a pathological condition. Rather, it occurs due to conditions that are apparently normal. The condition causes an increase of the total amount of leukocytes over normal level. There is not any association with any known disorder.

Chronic Leukocytosis

It is a type of Leukocytosis that persists for a long duration. Patients suffering from this disorder usually suffer from various discomforting symptoms, such as:

• Mild weakness
• Occasional fever
• Moderate loss of weight

Usually, patients suffering from this type of persistent Leukocytosis do not have any other medical problems.

Pathological leukocytosis

It is an unusual white blood cell disorder that typically arises in cases of poisoning, intoxication or infection. It may also occur after consumption of food that is very hot or abnormally altered.

Lymphocytic Leukocytosis

This is a condition marked by the presence of an unusually high amount of lymphocytes (lymph cells) in the bloodstream. The number of these lymph cells can rise in response to infections, especially those that are viral in nature. It may also increase due to some types of bacterial infection, like Tuberculosis. Abnormal increase in the number of lymph cells may also occur due to:

• Crohn’s disease
• Graves’ disease
• Cancerous conditions, such as Chronic Lymphocytic Leukemia or Lymphoma

Leukocytosis Causes

Some of the main causes of Leukocytosis are:

Bone marrow problems

The condition typically occurs when white blood cells are produced by the bone marrow in excessive amounts. An overproduction of WBCs often occurs due to the presence of disorders, such as Leukemia. In such cases, the white blood cells that are produced do not function like normal WBCs.

Infection

Leucocytosis typically results from an infection, as in Leukemia. The infection may be bacterial, viral or even parasitic in nature. The disorder often arises due to infections like Chicken Pox or Pneumonia.

Inflammation

The disease may also arise due to swelling that often occurs due to disorders like Osteoarthritis. Inflammation of the joints in arthritic conditions is a major cause of this disorder.

Medicines

The disease also arises as a side effect of medicines such as those that are used to cure inflammation, respiratory problems, cancer and mental disorders. Drugs like Epinephrine can give rise to this syndrome.

Stress

Individuals who undergo excessive physical or mental stress may also suffer from this condition. Leucocytosis may occur after intense exercise that takes a toll on physical health. It also occurs in post-operative patients and people suffering from seizures. Both physical as well as mental stress can lead to this ailment.

Tissue damage

Damage of body tissue, occurring from cancer, burns or heart disease, can be responsible for the development of this disorder.

The condition may also result from other factors, such as:

• Allergic reactions
• Convulsions
• Chemical or metabolic intoxication
• Chronic disorders
• Lack of oxygen
• Strong immune reactions
• Labor, associated with pregnancy

Leukocytosis Symptoms

The symptoms of this disease can vary from one patient to another, based on the underlying cause. However, certain symptoms are found to arise constantly in most sufferers irrespective of the causative factor. These include problems like:

• Bruising
• Dizziness
• Excessive bleeding
• Fainting
• Fatigue
• Fever
• Low appetite
• Mental confusion
• Respiratory difficulties
• Sweating
• Tingling pain in arms, legs or abdomen
• Vision problems
• Weakness
• Weight loss

Individuals with this disorder also typically suffer from troubles in thinking clearly. Patients of this condition often suffer from no symptoms at all. They may experience problems due to the underlying disease that acts as the cause of the condition.

Leukocytosis Diagnosis

The diagnosis of this condition involves:

Complete Blood Count (CBC)

CBC exactly determines the white blood cell count of a patient. The test helps doctors diagnose irregularities in the white blood cells. Naturally, it is often used for definitive diagnosis of Leukocytosis.

Peripheral Blood Smear (PBS)

This is an additional test that may be required if healthcare providers suspect some underlying bone marrow disorder. A PBS helps show the form and shape of the white blood cells. It also reveals whether the patient has excessive amounts of any particular form of WBC in his or her blood. Caregivers may also conduct other tests to check for infections, bone marrow disorders or some other potential cause of this disease.

Healthcare providers also ask you about the symptoms and the health history of the patient. Patients may also be asked whether they are suffering from allergenic or any other medical condition. Any recent physical or emotional stress should also be reported to doctors. A full physical check-up may also be done to rule presence of other physical conditions.

Leukocytosis Differential Diagnosis

The differential diagnosis of Leukocytosis involves distinguishing the disorder from other conditions like:

• Appendicitis
• Asplenia
• Acute Lymphoblastic Leukemia
• Acute Myelocytic Leukemia
• Bacteremia
• Pertussis
• Polycythemia
• Down Syndrome
• Polycythemia Vera
• Sickle Cell Anemia
• Hypereosinophilic Syndrome
• Leukocyte Adhesion Deficiency

Leukocytosis Treatment

The treatment of this disorder usually aims at curing its underlying cause. Some patients, particularly those suffering from infections, do not necessarily require any treatment. The disease usually resolves if the infection is cured in time. Drugs, antibiotics and steroids can help lower uric acid levels in the bloodstream. This can help treat Leucocytosis. If bone marrow disorders are responsible for Leucocytosis, treatment can involve the use of blood transfusions, chemotherapy and bone marrow transplants.

Intravenous (IV) fluids

Leucocytosis patients often require administration of liquids through an IV – a tube inserted into the vein of a patient. Additional fluids are passed into the blood vessels of sufferers to help them recuperate.

Medicines

Medications can involve antibiotics, which can prevent or cure an underlying infection. It can stop patients from suffering due to sepsis, an acute infection in blood. Steroids may also be given to reduce inflammation and lower the number of white blood cells. Antacids help reduce acid level in the urine. Medications may also be administered to reduce the amount of uric acid in bloodstream and prevent greater damage to body cells.

Bone marrow transplant (BMT)

It involves replacement of diseased bone marrow with marrow that is healthy. Marrow is usually collected from a healthy donor. In some cases, marrow may be collected from the body of the patient if his/her cancer is not active. The transplantation is conducted while patients are in an IV in the hospital.

While BMT may resolve the condition, it can also give rise to very acute health problems. Patients may also need to remain hospitalized for about a month after the transplantation.

Blood transfusion

The procedure involves complete or partial blood transfusion through an IV. Doctors also test the blood to make sure that it is free from disorders like HIV and Hepatitis.

Leukocytoreduction

The process lowers the amount of white blood cells in the bloodstream. It can also help prevent another condition known as Leukostasis, which occurs when the WBCs cluster together in the blood.

The process can be carried out in two ways:

Leukapheresis

It involves using an IV to take out blood from the body and removing the white blood cells (WBCs) with the help of a machine. The blood, cleared of the WBCs, may be used for laboratory analysis or returned to the body of the patient. In some cases, it may be stored and passed into the body of another person.

Chemotherapy

Also referred to as “chemo”, the process involves use of a particular medication that is frequently used for the treatment of a cancerous condition, such as leukemia. The technique is useful for:

• Reduction or destruction of tumor cells, often followed by surgery
• Reduction of the amount of white blood cells (WBCs) in blood
• Shrinking of cancerous lymph nodes
• Treatment of leukemia

Chemotherapy can produce various side effects. Due to this reason, healthcare providers determine the type and duration of Chemotherapy required by patients. Diverse medications and frequent blood tests are required to cure cancerous conditions. Blood tests show the amount of Chemo required by the body and the working of the physical system. Healthcare providers closely monitor the health of patients and reduce any side effects that arise due to use of Chemo. Chemotherapy is successful in curing certain cancers. Even if it does not cure patients completely, it may at least help them live longer or feel better.

In some cases, the amount of white blood cells (WBCs) in the body may come back to normal with or without use of medical treatment. If Leukocytosis arises due to a particular medicine, its usage may be stopped by a healthcare provider. It is not recommended to stop use of a medicine unless advised by a caregiver. If an allergy causes the condition, care providers may ask patients to avoid the allergenic substance.

Leukocytosis Prognosis

The condition has a relatively good outcome if treatment successfully manages to reduce the amount of white blood cells to normal. Successfully curing the underlying cause can make the WBC count return to normal.

Leukocytosis during Pregnancy

Pregnancy results in various structural as well as functional changes within the human body. Rise in the levels of pregnancy hormones, particularly estrogen and progesterone, can give rise to such changes. Growing requirements of the uterus, placenta and the fetus can also give rise to such problems. During pregnancy, the amount of leukocytes is found to rise considerably in peripheral blood. The amount of white blood cells may rise up to 15,000/µl. During labor or after delivery, the WBC count may even go higher. The total amount of WBCs also raises enough to fill the increased volume of blood. It is not known what exactly causes an increase in the number of Leukocytes. However, it is typically believed to occur due to a hormonal response. The total WBC count is normal if patients do not suffer from sore throat, fever, urinary difficulties or other symptoms that indicate an infection.

Leukocytosis and Thrombocytosis

Leukocytosis is often found to arise along with Thrombocytosis. The two conditions may be confused by patients due to the presence of infection in both cases. Leukocytosis leads to an abnormal rise in the amount of Leucocytes in blood. It arises due to an infection, such as in Leukemia. However, Thrombocytosis involves rise in the amount of platelets in the bloodstream which tends to result in the formation of clots. The disease is associated with many chronic infections, neoplasms and other disorders.

Leukocytosis is not a very serious condition. If treated well, it can be cured successfully and found to show a good prognosis.

References:

http://emedicine.medscape.com/article/956278-overview

http://www.drugs.com/cg/leukocytosis.html

http://www.healthbeyondhype.com/info/digestive-leukocytosis/

http://www.britannica.com/EBchecked/topic/337748/leukocytosis