Neutrophilia

Neutrophilia (or neutrophil leukocytosis) is a condition where a person has a high number of neutrophil granulocytes in their blood.

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Neutrophils are the primary white blood cells that respond to a bacterial infection, so the most common cause of marked neutrophilia is a bacterial infection.

Neutrophils are also increased in any acute inflammation, so will be raised after a heart attack or other infarct.

As well as increasing in number, neutrophils show other changes in infection and inflammation. The neutrophils tend to be younger, as they are being released more quickly; this is called a left shift. 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.

Drugs, such as prednisone, have the same effect as cortisol, causing marginated neutrophils to enter the blood stream. Nervousness will very slightly raise the neutrophil count because of this effect.

A neutrophilia might also be the result of a malignancy. Chronic myelogenous leukemia (CML or chronic myeloid leukaemia) is a disease where the blood cells proliferate out of control. These cells may be neutrophils. Neutrophilia can also be caused by appendicitis.

See also

• Granulocytosis (often used as synonym)
• Neutropenia (having too few neutrophils)