Granulocytosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Lakshmi Gopalakrishnan, M.B.B.S. [2]

Synonyms and Keywords: Neutrophilia, congenital neutrophilia

Overview

Granulocytosis is defined as the presence of an increased number of granulocytes, a category of white blood cells present in the peripheral blood. Often, the word refers to an increased neutrophil granulocyte count, as neutrophils are the main granulocytes. An increase in eosinophil granulocyte is known as eosinophilia. In cardiovascular disease, increased white blood cell counts have been shown to indicate a worse prognosis.

Common Causes

Granulocytosis can be a feature of a number of diseases:

Causes by Organ System

Cardiovascular No underlying causes
Chemical / poisoning No underlying causes
Dermatologic No underlying causes
Drug Side Effect Aminophylline, Dinoprostone, Filgrastim, Granulocyte colony stimulating factor, Granulocyte-macrophage colony stimulating factor, Lithium, Sulprostone, Thrombin human
Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental No underlying causes
Gastroenterologic Acute pancreatitis, Gallbladder empyema
Genetic Acute intermittent porphyria, Hereditary neutrophilia, Hyperimmunoglobulinemia D and periodic fever syndrome, Leukocyte adhesion deficiency type 1, Leukocyte adhesion deficiency type 2, Leukocyte adhesion deficiency type 3, Recurrent hereditary polyserositis
Hematologic Acute intermittent porphyria, Leukemoid reaction, Leukocyte adhesion deficiency type 1, Leukocyte adhesion deficiency type 2, Leukocyte adhesion deficiency type 3, Lymphangitis, Polycythaemia rubra vera, Recurrent hereditary polyserositis
Iatrogenic Splenectomy
Infectious Disease Congenital syphilis, Hantavirus
Musculoskeletal / Ortho No underlying causes
Neurologic No underlying causes
Nutritional / Metabolic No underlying causes
Obstetric/Gynecologic No underlying causes
Oncologic Acute myeloid leukemia, Acute promyelocytic leukemia, Chronic myeloid leukaemia, Mast cell leukemia, Polycythaemia rubra vera
Opthalmologic No underlying causes
Overdose / Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary Bronchiolitis obliterans organizing pneumonia, Extrinsic allergic alveolitis, Wegener granulomatosis, Severe acute respiratory syndrome
Renal / Electrolyte Wegener granulomatosis
Rheum / Immune / Allergy Adult-onset Still disease, Urate crystal arthropathy, Wegener granulomatosis
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order

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.[1][2]

Related Chapters

References

  1. 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. PMID 16724080. doi:10.1038/sj.jp.7211513. 
  2. 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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