Neutrophilia

Neutrophilia (also called neutrophil leukocytosis or occasionally neutrocytosis) is leukocytosis of neutrophils, that is, a high number of neutrophils in the blood.[1] Because neutrophils are the main type of granulocytes, mentions of granulocytosis often overlap in meaning with neutrophilia.

Neutrophilia
Neutrophils with a segmented nuclei surrounded by erythrocytes, the intra-cellular granules are visible in the cytoplasm (Giemsa stained)

The opposite of neutrophilia is neutropenia.

Causes

Neutrophils are the primary white blood cells that respond to a bacterial infection, so the most common cause of neutrophilia is a bacterial infection, especially pyogenic infections.[2]

Neutrophils are also increased in any acute inflammation, so will be raised after a heart attack,[2] other infarct or burns.[2]

Some drugs, such as prednisone, have the same effect as cortisol and adrenaline (epinephrine), causing marginated neutrophils to enter the blood stream.

A neutrophilia might also be the result of a malignancy. Chronic myelogenous leukemia (CML or chronic myeloid leukaemia) is a disease where the blood cells proliferate out of control. These cells may be neutrophils. Neutrophilia can also be caused by appendicitis and splenectomy.[3]

Primary neutrophilia can additionally be a result of leukocyte adhesion deficiency.[4]

"Left shift"

A "left shift" refers to the presence of increased proportions of younger, less well differentiated neutrophils and neutrophil-precursor cells in the blood. This generally reflects early or premature release of myeloid cells from the bone marrow, the site where neutrophils are generated. A severe neutrophilia with left shift is referred to as a leukemoid reaction. The leukocyte alkaline phosphatase (LAP) score, which refers to the amount of alkaline phosphatase per neutrophil, will increase. In a severe infection, toxic granulation changes happen to the neutrophils.

This can resemble Pelger-Huet anomaly.[5][6]

See also

References
  1. "neutrophilia" at Dorland's Medical Dictionary
  2. Table 12-6 in: Mitchell, Richard Sheppard; Kumar, Vinay; Abbas, Abul K; Fausto, Nelson (2007). Robbins Basic Pathology. Philadelphia: Saunders. ISBN 978-1-4160-2973-1. 8th edition.
  3. "bloodandcancerclinic". Archived from the original on 21 May 2013. Retrieved 10 April 2013.
  4. "Titre" (PDF). Retrieved 2019-11-16.
  5. Mohamed IS, Wynn RJ, Cominsky K, et al. (June 2006). "White blood cell left shift in a neonate: a case of mistaken identity". J Perinatol. 26 (6): 378–80. doi:10.1038/sj.jp.7211513. PMID 16724080.
  6. Shmuely H, Pitlik SD, Inbal A, Rosenfeld JB (June 1993). "Pelger-Huët anomaly mimicking 'shift to the left'". Neth J Med. 42 (5–6): 168–70. PMID 8377874.
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