Causes of neutrophilia and treatment

Headnote

Infection is the most common cause of neutrophilia, says Dr Rebecca Auer

Neutrophilia is an increase in circulating neutrophils above that expected in a healthy individual of the same age, sex, race and physiological status. TMs represents an increase in the neutrophil count above 7.5 ? 1è'/1 and is one of the most frequently observed changes in the FBC. It is usually due either to a redistribution of white cells or an increase hi bone marrow output.

Neutrophilia can occur as a normal physiological process. Healthy neonates have a higher neutrophil count and for infants less than one month old the normal range is as high as 26 xl09/l. Women of childbearuig age have higher neutrophil counts than men, with the count varying during the menstrual cycle.

Pregnancy causes a marked rise in the neutrophil count, which rises even further during and after labour. Vigorous exercise can double the neutrophil count by altering the distribution of white cells within the circulation.

Neutrophilia in pathological conditions is usually due to an increased output from the bone marrow. The major causes of neutrophilia are outlined in the box.

Reactive neutrophilia, where the cause is due to extrinsic factors rather than a primary haemopoietic disorder, is common, with infection being the most common cause.

Diagnosis

Most often neutrophilia will be a reactive phenomenon, usually to a bacterial infection where fever as a result of...