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Published on: October 19, 2014
[Leucocytosis: etiology and diagnostic approach]
F Kroschinsky1, U Schäkel, G Ehninger
1Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland. frank.kroschinsky@uniklinikum-dresden.de
Insights
Leucocytosis, an elevated white blood cell count, requires differentiating leukocyte subpopulations for diagnosis. While often benign, it can indicate serious conditions like leukemia, necessitating further tests.
Area of Science:
- Hematology
- Clinical Diagnostics
- Immunology
Background:
- Leucocytosis (elevated white blood cell count) is a common clinical finding.
- Initial diagnostic steps involve differentiating various leukocyte subpopulations.
- Physiological causes include stress, while immune responses to infection, allergy, and autoimmune diseases alter leukocyte levels.
Purpose of the Study:
- To outline the diagnostic approach for leucocytosis.
- To differentiate common causes from rarer, more serious conditions.
- To highlight the role of leukocyte subpopulation analysis in clinical practice.
Main Methods:
- Clinical observation and diagnostic workup.
- Leukocyte subpopulation differentiation.
- Review of etiological factors for leucocytosis.
Main Results:
- Neutrophilic leucocytosis is often physiological (e.g., post-stress).
- Immune reactions (infection, allergy, autoimmune) characteristically alter leukocyte populations.
- Hematological malignancies like leukemia or lymphoma are less frequent causes of leucocytosis.
Conclusions:
- Differentiating leukocyte subpopulations is crucial for diagnosing leucocytosis.
- Bone marrow examination and genetic analyses are essential for diagnosing hematological malignancies.
- A systematic approach aids in distinguishing benign from malignant causes of elevated white blood cells.
Abstract:
Leucocytosis is frequently diagnosed in clinical practice. The first step in the diagnostic approach should be based on differentiation of the leucocyte subpopulations. Neutrophilic leucocytosis can be observed physiologically after physical or mental stress. Furthermore, almost all immune reactions due to infection, allergy or autoimmune diseases are associated with changes in the leucocyte populations. An elevation of white blood cells caused by acute or chronic leukemia, or malignant lymphoma is less frequent. For the diagnosis of hematological malignancies, bone marrow examinations and genetic analyses are necessary.
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