neutrophilia

Differential diagnosis:

• Infection
• Malignancy: If very high WBC, consider acute leukemia
• Inflammatory/autoimmune conditions
• De-margination: Stress response, steroids

• UpToDate table: classification of neutrophilia
• approach to the patient with neutrophilia

(>7500–10,000/µL)

Infection

Usually bacterial; ± toxic granulations, Döhle bodies

參考➡️ Leukocytic Inclusions—Döhle Bodies—Associated with Platelet Abnormality (The May-Hegglin Anomaly) Report of a Fami1y and Review of the Literature

Inflammation

Burn, tissue necrosis, MI, PE, collagen vascular disease

Drugs and toxins

Corticosteroids, β-agonists, lithium, G-CSF; cigarette smoking

Stress

Release of endogenous glucocorticoids and catecholamines

Marrow stimulation

Hemolytic anemia, immune thrombocytopenia

Asplenia

Surgical, acquired (sickle cell), congenital (dextrocardia)

Neoplasm

Can be 1° (MPN) or paraneoplastic (eg, carcinomas of lung, GI)

Leukemoid reaction

參考➡️ An update on the etiology and diagnostic evaluation of a leukemoid reaction

50,000/µL + left shift, not due to leukemia; unlike CML, ↑ LAP