Leukocytosis may be a temporary response to an infection or injury as the body is healing naturally, or it can be a sign of disease. It may develop as a side effect of some medications, or it may reflect an underlying autoimmune disease.
Leukocytosis can involve all types of white blood cells or just a few. The effects will depend on which type of white blood cell is affected.
Symptoms of Leukocytosis
Leukocytes have many effects on the body. Normally, these cells travel throughout the bloodstream, and they are also present in the lining of many organs, such as the intestines. They recognize infectious pathogens, like viruses and bacteria, and they activate the immune response to fight infections.
Leukocytes are directed to areas of the body that have been harmed by injury or disease, and they help repair these damaged tissues and organs.
While a person may be totally healthy and experience physiological leukocytosis (an increase in the number of circulating leukocytes) in response to extreme physical activity or environmental stress, most cases of leukocytosis are secondary to a medical condition or medication.
Leukocytes respond to underlying medical conditions, which activate defense mechanisms in the body to help fight off infection or protect the body. It is also possible for an underlying condition to cause persistent leukocytosis.
Common body responses to underlying conditions causing leukocytosis include:
Warmth, swelling, tenderness, pain, or redness in a specific area of the bodyFever, sweats, chills Fatigue Loss of appetite, vomiting, diarrhea Sore throat, congestion, runny nose Itching, skin rash
Causes of Leukocytosis
A healthy person can experience physiological leukocytosis in response to extreme physical activity or environmental stress, but most cases of leukocytosis are secondary to a medical condition or medication.
There are several different conditions that can cause leukocytosis. Infections and injuries are the most common causes in which temporary leukocytosis indicate the body is healing. Many diseases that require treatment can also cause leukocytosis.
Causes of leukocytosis include:
Infections Trauma Surgery Autoimmune conditions, like lupus (causes chronic inflammation that can damage organs), inflammatory bowel disease (Crohn’s disease or ulcerative colitis), or rheumatoid arthritis (causes joint pain and swelling) Some types of cancer, especially blood cancer
Leukocytosis that is caused by cancer can present with symptoms such as fever and fatigue. However, if cancer is present, leukocytes may no longer behave normally.
In addition, too many leukocytes may present their own problems, like leukostasis, in which plugs of white cells are seen in small blood vessels.
What Medications Cause Leukocytosis
Leukocytosis can be a side effect of some medications. Examples include corticosteroids, beta agonists, lithium, epinephrine, and colony-stimulating factors.
If you have leukocytosis without a clear reason, make sure to ask your healthcare provider whether it could be a medication side effect, or check the labels on your medications, which may indicate this.
How to Treat Leukocytosis
Often, interventions that treat the underlying cause of leukocytosis will relieve the symptoms, but treatment can take a while to work. You may also need medical management for the symptoms of leukocytosis as your white cell count is returning to a normal level.
Treatments for symptoms of the underlying conditions associated with leukocytosis may include:
Antihistamines to reduce symptoms of inflammation Cold medicines to reduce sore throat, congestion, runny nose Tylenol (acetaminophen) or nonsteroidal anti-inflammatory drugs (NSAIDs) such as Advil (ibuprofen) or Aleve (naproxen) to reduce fever, swelling, and pain Steroids or other anti-inflammatory drugs to reduce inflammation
An infection might be treated with antibiotics. For blood cancers and autoimmune conditions, the treatment will be specific to the condition. Blood cancers often are treated with chemotherapy. Autoimmune conditions are treated with anti-inflammatory drugs and drugs that suppress the immune response.
Are There Tests to Diagnose the Cause of Leukocytosis?
Leukocytosis is diagnosed with a complete blood count (CBC) and is defined as a white blood cell (WBC) count higher than 11,000 per cubic millimeter (11.0 × 109 per liter) in adults who are not pregnant.
The normal values of each type of leukocyte and the percentage of each type is standardized, but may vary slightly between different labs.
Some tests used to identify the cause of leukocytosis include:
A throat culture, blood culture, or urine culture to identify a bacterial or fungal infection A peripheral blood smear to identify abnormal cells Specialized blood tests, such as rheumatoid factor and antinuclear antibody test to identify inflammatory disorders such as rheumatoid arthritis or lupus Endoscopy or colonoscopy to identify signs of inflammation in the digestive system Bone marrow biopsy to identify blood cancer
You might need to have one or more of these tests, but it’s unlikely that you would need all of them. Your healthcare provider will decide which of these you need based on a preliminary evaluation.
Additionally, with leukocytosis, the excess white blood cells may have normal features, or they can be abnormal. With blood cancers, like leukemia, some leukocytes can have an abnormal shape and function, with especially harmful effects on the body.
When to See a Healthcare Provider
Leukocytosis can be a normal part of healing and recovery from illness, or it can be a sign of an underlying disease that requires diagnostic testing and treatment. If you have signs and symptoms of leukocytosis that are causing discomfort or lasting more than a few days, you should call your healthcare provider for advice or make an appointment.
Get prompt medical attention if you or your child has any of the following symptoms:
Wheezing or trouble breathing Painful joint swellingPainful or severe lymph node swelling Severe chills, sweats, or feverFever of unexplained originSevere vomiting or diarrhea Changes in consciousness, dizziness, or trouble concentratingUnexplained weight lossChange in energy levelEase of bleeding from mucosal surfaces or skin
These can be signs of a rapid and potentially dangerous white blood cell reaction or a serious underlying medical condition.
Summary
Leukocytosis is a high number of white blood cells. It can occur as a normal response to infections, injuries, and illness as the body is healing. In these situations, the symptoms can include a fever, chills, sweating, or fatigue, and will usually go away once the illness resolves.
Sometimes leukocytosis occurs with inflammatory or autoimmune conditions or cancer. Diagnostic tests can identify the type and cause of leukocytosis.
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