Neutrophilia

High levels of neutrophil in the blood results in neutrophilia; neutrophils are White Blood Cells or WBC that are assigned the task of killing/fighting off foreign matter like fungi and bacteria in the body. They are an important part of the body's defense force. An adequate amount of production and distribution of neutrophils is very important. However during an infection in the body, an elevated level of neutrophils can be found, with equal numbers in marginal and circulating pool.

The site of infection generates chemotactic agents and attracts neutrophils to the affected part. During recovery the flow of cells decreases from the marrow and this in turn decreases the amount of neutrophils. Neutrophilia is the most common form of leukocytosis - a condition wherein the blood has an increased number of leukocytes. When the cells shift from the marginal to circulating pool without an increase in the total blood granulocyte pool or if there is an increase in size of the TGBP, it could result in Neutrophilia.

Women in their childbearing age have a higher neutrophil count when compared to men. Pregnancy also leads to high neutrophil count and this may tend to increase during childbirth.

Neutrophilia occurrence

True Neutrophilia: True Neutrophilia occurs in most cases of infection and total blood granulocyte pool, the TGBP, may increase 5-6 times the normal level. At the onset of the infection, Neutrophilia count decreases and then it rises to very high levels.

Shift Neutrophilia: Shift Neutrophilia as the name indicates is transient (e.g. during heavy exercise) and may occur in association to other conditions. The change in numbers may last only for a few minutes. There is no change in the inflow of neutrophils from the bone marrow.

Causes for Neutrophilia

Neutrophilia is caused due to increase in bone marrow output or redistribution of white cells. Though there are numerous possibilities for an elevated level of neutrophils in the blood, the most common causes include:

• Infections, caused by cocci, certain fungi, bacteria (local or generalized), viruses (chickenpox, herpes simplex) and parasites (hepatic amebiasis, Pneumocystis carinii) lead to Neutrophilia
  
  
• Non-infectious inflammation like burns, post surgery, acute attack of gout, asthma, rheumatic fever, autoimmune conditions, any kind of trauma, tissue damage, myocardial infarction can also lead to Neutrophilia
  
• Acute and sudden hemorrhage can lead to inflammation and thus lead to Neutrophilia.
  
  
• Poisoning from sources like mercury, lead, digitalis, camphor, quinidine and certain insects can also lead to Neutrophilia
  
  
• Metabolic changes in the body like diabetic ketoacidosis, uremia, etc can cause Neutrophilia
  
  
• Malignancies and other kinds of spreading cancer, where the tumor outgrows the blood supply can lead to neutrophilia
  
  
• Physiologic Neutrophilia is also caused by heavy exercise, epinephrine injections, etc
  
  
• Other causes for Neutrophilia could include seizures, anemia, increase or decrease in platelet count, short or long term usage of corticosteroids, Cushing disease etc
  
  
• Cigarette smoking can cause inflammation and thus lead to Neutrophilia.
  
  
• High levels of stress can also lead to increase in levels of neutrophils and thus cause Neutrophilia.
  
  
• Neutrophilia may be present without any particular cause that can be identified, this type of neutrophilia is called chronic idiopathic neutrophilia.

Diagnosis

Most often neutrophilia is a reactive phenomenon and can be diagnosed through blood tests. A physical examination is done and the medical history of the patient is studied. A complete blood count investigation and a series of blood tests are ordered for. In a few cases bone marrow aspiration is ordered for. The commons symptoms reported include decreased body temperature or hypothermia, dyspnea (labored breathing) or tachypnea (rapid breathing) and sometimes bleeding.