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American Family Physician Dec 2015An elevated white blood cell count has many potential etiologies, including malignant and nonmalignant causes. It is important to use age- and pregnancy-specific normal...
An elevated white blood cell count has many potential etiologies, including malignant and nonmalignant causes. It is important to use age- and pregnancy-specific normal ranges for the white blood cell count. A repeat complete blood count with peripheral smear may provide helpful information, such as types and maturity of white blood cells, uniformity of white blood cells, and toxic granulations. The leukocyte differential may show eosinophilia in parasitic or allergic conditions, or it may reveal lymphocytosis in childhood viral illnesses. Leukocytosis is a common sign of infection, particularly bacterial, and should prompt physicians to identify other signs and symptoms of infection. The peripheral white blood cell count can double within hours after certain stimuli because of the large bone marrow storage and intravascularly marginated pools of neutrophils. Stressors capable of causing an acute leukocytosis include surgery, exercise, trauma, and emotional stress. Other nonmalignant etiologies of leukocytosis include certain medications, asplenia, smoking, obesity, and chronic inflammatory conditions. Symptoms suggestive of a hematologic malignancy include fever, weight loss, bruising, or fatigue. If malignancy cannot be excluded or another more likely cause is not suspected, referral to a hematologist/oncologist is indicated.
Topics: Education, Medical, Continuing; Humans; Leukocyte Count; Leukocytes; Leukocytosis; Practice Guidelines as Topic
PubMed: 26760415
DOI: No ID Found -
Mayo Clinic Proceedings Jul 2005A complete blood cell count (CBC) is one of the most common laboratory tests in medicine. For example, at our institution alone, approximately 1800 CBCs are ordered... (Review)
Review
A complete blood cell count (CBC) is one of the most common laboratory tests in medicine. For example, at our institution alone, approximately 1800 CBCs are ordered every day, and 10% to 20% of results are reported as abnormal. Therefore, it is in every clinician's interest to have some understanding of the specific test basics as well as a structured action plan when confronted with abnormal CBC results. In this article, we provide practical diagnostic algorithms that address frequently encountered conditions associated with CBC abnormalities including anemia, thrombocytopenia, leukopenia, polycythemia, thrombocytosis, and leukocytosis. The objective is to help the nonhematologist recognize when a subspecialty consultation is reasonable and when it may be circumvented, thus allowing a cost-effective and intellectually rewarding practice.
Topics: Adult; Algorithms; Anemia; Blood Cell Count; Cost-Benefit Analysis; Diagnosis, Differential; Hematologic Diseases; Hematology; Humans; Leukocytosis; Leukopenia; Polycythemia; Practice Patterns, Physicians'; Referral and Consultation; Thrombocytopenia; Thrombocytosis
PubMed: 16007898
DOI: 10.4065/80.7.923 -
European Heart Journal Apr 2016Atherosclerosis, the major underlying cause of cardiovascular disease, is characterized by a lipid-driven infiltration of inflammatory cells in large and medium... (Review)
Review
Atherosclerosis, the major underlying cause of cardiovascular disease, is characterized by a lipid-driven infiltration of inflammatory cells in large and medium arteries. Increased production and activation of monocytes, neutrophils, and platelets, driven by hypercholesterolaemia and defective high-density lipoproteins-mediated cholesterol efflux, tissue necrosis and cytokine production after myocardial infarction, or metabolic abnormalities associated with diabetes, contribute to atherogenesis and athero-thrombosis. This suggests that in addition to traditional approaches of low-density lipoproteins lowering and anti-platelet drugs, therapies directed at abnormal haematopoiesis, including anti-inflammatory agents, drugs that suppress myelopoiesis, and excessive platelet production, rHDL infusions and anti-obesity and anti-diabetic agents, may help to prevent athero-thrombosis.
Topics: Atherosclerosis; Blood Platelets; Cholesterol; Hematopoiesis; Hematopoiesis, Extramedullary; Hematopoietic Stem Cells; Humans; Leukocytosis; Metabolic Diseases; Monocytes; Myelopoiesis; Myeloproliferative Disorders; Neutrophils; Risk Factors; Thrombopoiesis; Thrombosis
PubMed: 26869607
DOI: 10.1093/eurheartj/ehv718 -
Tidsskrift For Den Norske Laegeforening... Aug 2014
Topics: Adult; Female; Humans; Leukapheresis; Leukocytosis; Middle Aged
PubMed: 25096431
DOI: 10.4045/tidsskr.13.1559 -
Deutsches Arzteblatt International Mar 2018
Topics: Aged; Humans; Leukemia; Leukocytosis; Male; Skin Neoplasms
PubMed: 29607809
DOI: 10.3238/arztebl.2018.0189 -
Blood Sep 2009
Topics: Bone Marrow; Cell Nucleus; Eosinophilia; Female; Humans; Leukocyte Count; Leukocytosis; Middle Aged; Mycosis Fungoides; Skin Neoplasms
PubMed: 19736668
DOI: 10.1182/blood-2009-02-206599 -
Immunological Reviews Nov 2014Monocytes are part of the vertebrate innate immune system. Blood monocytes are produced by bone marrow and splenic progenitors that derive from hematopoietic stem cells... (Review)
Review
Monocytes are part of the vertebrate innate immune system. Blood monocytes are produced by bone marrow and splenic progenitors that derive from hematopoietic stem cells (HSCs). In cardiovascular disease, such as atherosclerosis and myocardial infarction, HSCs proliferate at higher levels that in turn increase production of hematopoietic cells, including monocytes. Once produced in hematopoietic niches, monocytes intravasate blood vessels, circulate, and migrate to sites of inflammation. Monocyte recruitment to atherosclerotic plaque and the ischemic heart depends on various chemokines, such as CCL2, CX3 CL1, and CCL5. Once in tissue, monocytes can differentiate into macrophages and dendritic cells. Macrophages are end effector cells that regulate the steady state and tissue healing, but they can also promote disease. At sites of inflammation, monocytes and macrophages produce inflammatory cytokines, which can exacerbate disease progression. Macrophages can also phagocytose tissue debris and produce pro-healing cytokines. Additionally, macrophages are antigen-presenting cells and can prime T cells. The tissue environment, including cytokines and types of inflammation, instructs macrophage specialization. Understanding monocytosis and its consequences in disease will reveal new therapeutic opportunities without compromising steady state functions.
Topics: Animals; Cardiovascular Diseases; Cell Differentiation; Cell Movement; Hematopoietic Stem Cells; Humans; Inflammation; Leukocytosis; Macrophages; Monocytes; Myeloid Progenitor Cells; Myelopoiesis; Organ Specificity
PubMed: 25319334
DOI: 10.1111/imr.12219 -
Pathogens and Disease Oct 2016The significant and sometimes dramatic rise in the number of circulating white blood cells (leukocytosis) in infants suffering from pertussis (whooping cough) has been... (Review)
Review
The significant and sometimes dramatic rise in the number of circulating white blood cells (leukocytosis) in infants suffering from pertussis (whooping cough) has been recognized for over a century. Although pertussis is a disease that afflicts people of all ages, it can be particularly severe in young infants, and these are the individuals in whom leukocytosis is most pronounced. Very high levels of leukocytosis are associated with poor outcome in infants hospitalized with pertussis and modern treatments are often aimed at reducing the number of leukocytes. Pertussis leukocytosis is caused by pertussis toxin, a soluble protein toxin released by Bordetella pertussis during infection, but the exact mechanisms by which this occurs are still unclear. In this minireview, I discuss the history of clinical and experimental findings on pertussis leukocytosis, possible contributing mechanisms causing this condition and treatments aimed at reducing leukocytosis in hospitalized infants. Since recent studies have detailed significant associations between specific levels of pertussis leukocytosis and fatal outcome, this is a timely review that may stimulate new thinking on how to understand and combat this problem.
Topics: Antibodies, Monoclonal; Bordetella pertussis; Exchange Transfusion, Whole Blood; Extracorporeal Membrane Oxygenation; History, 19th Century; History, 20th Century; History, 21st Century; Host-Pathogen Interactions; Humans; Infant; Leukocytes; Leukocytosis; Lymph Nodes; Pertussis Toxin; Survival Analysis; Whooping Cough
PubMed: 27609461
DOI: 10.1093/femspd/ftw087 -
Frontiers in Immunology 2022Immune-mediated cerebellar ataxias (IMCAs) are common in paraneoplastic cerebellar degeneration (PCD) but rarely occur in patients with neuronal surface antibodies...
BACKGROUND
Immune-mediated cerebellar ataxias (IMCAs) are common in paraneoplastic cerebellar degeneration (PCD) but rarely occur in patients with neuronal surface antibodies (NSAbs). Although cerebellar ataxias (CAs) associated with anti-NMDAR and anti-CASPR2 have been reported in a few cases, they have never been studied systematically. This study aimed to analyze the characteristics of anti-NSAbs-associated CAs.
METHODS
A retrospective investigation was conducted to identify patients using the keywords and . We collected the clinical data of 14 patients diagnosed with anti-NSAbs-associated CAs.
RESULTS
The median age was 33 years (16-66), and the male-to-female ratio was 4:3. Nine were positive for NMDAR-Ab, two for LGI1-Ab, two for CASPR2-Ab, and one for AMPA2R-Ab. CAs were initial symptoms in three patients and presented during the first two months of the disease course (10 days on average) among the rest of the patients. After the immunotherapy, two cases were free from symptoms, and eight cases recovered satisfactorily (10/14, 71.4%). Compared with other causes of IMCAs, anti-NSAbs were more frequently associated with additional extra-cerebellar symptoms (85.7%), mostly seizures (78.6%) and mental abnormalities (64.3%). In the CSF analysis, pleocytosis was detected in ten patients (71.4%) and oligoclonal bands (OB) were observed in nine patients (64.3%). Moreover, compared with PCD and anti-GAD65-Ab-associated CAs, anti-NSAbs-associated CAs showed a better response to immunotherapy.
CONCLUSION
IMCAs are rare and atypical in autoimmune encephalitis with neuronal surface antibodies. Compared with other forms of IMCAs, more symptoms of encephalopathy, a higher rate of pleocytosis and positive OB in CSF, and positive therapeutic effect were the key features of anti-NSAbs-associated CAs.
Topics: Adult; Autoantibodies; Cerebellar Ataxia; Female; Humans; Leukocytosis; Male; Paraneoplastic Cerebellar Degeneration; Retrospective Studies
PubMed: 35250990
DOI: 10.3389/fimmu.2022.813926 -
Blood Dec 2013
Topics: Aged; Anemia; Bone Marrow; Breast Neoplasms; Female; Humans; Leukemia, Myeloid, Acute; Leukocytosis; Thrombocytopenia
PubMed: 24479132
DOI: 10.1182/blood-2013-08-520494