Neutrophilia refers to an above-normal number of neutrophil granulocytes (neutrophils) in the blood. Neutrophilia is one of several possible forms of leukocytosis, which is commonly used to describe an increase in white blood cells, which include neutrophils. There are many endogenous and exogenous factors, including immune responses, that cause a temporary or permanent excess of neutrophil granulocytes.
What is neutrophilia?
The abbreviated name neutrophils is often used for neutrophil granulocytes, which are part of the innate immune system. They represent a specific form of white blood cells (leukocytes) and make up the largest proportion of leukocytes overall. A temporary or permanent increase in the number of neutrophils in the blood above normal levels is called neutrophilia. Neutrophilia is thus a special form of leukocytosis, which is generally used to describe an increase in the number of leukocytes. The neutrophil granulocytes belong to the non-specific innate immune defense. They are permanently “on patrol” in the blood and in inactive form also distributed as “posts” in the tissue. A rapid and short-lasting increase in their number in the blood may be an immune reaction or may indicate a disease of the neutrophils themselves. The majority of neutrophils are so-called segment-nucleated, differentiated neutrophils, of which 3,000 to 5,800 normally circulate in the blood per microliter. Rod-nucleated neutrophil granulocytes, which are not yet fully differentiated, normally appear with a number of circa 150 to 400 per microliter of blood.
Causes
Neutrophilia can be caused by many endogenous and exogenous factors and triggers. In most cases of a transient increase in neutrophil granulocytes, only endogenous causes such as the release of stress hormones-particularly epinephrine-play the major role. In external circumstances that cause acute stress with an abrupt increase in adrenaline levels, the body is prepared for short-term muscular and mental peak performance for flight or attack. This also includes the precaution of losing as little blood as possible in the event of injury by constricting the peripheral blood vessels and being able to react more quickly to germs that use possible external injuries as a port of entry. As a precautionary measure, the immune system induces a temporary neutrophilia that subsides after about an hour. The immune system also triggers neutrophilia in acute inflammation, severe injury, surgery, and infection, as well as when glucocorticoid levels are elevated. The drastic increase in the number of neutrophil granulocytes is usually accompanied by a so-called left shift. Increased numbers of immature rod-nucleated neutrophils are released from the bone marrow into the bloodstream. A similar process as a reaction of the immune system occurs in chronic inflammation and in some types of neoplasia (cancer). A particularly severe form of neutrophilia occurs in chronic granulocytic leukemia, such as myeloid leukemia, in which unchecked proliferation of leukocyte precursor cells occurs during the course of the disease-untreated-due to genetic factors.
Symptoms, complaints, and signs
An increase in neutrophil granulocytes above normal is usually completely asymptomatic. At most, symptoms occur in association with the factors that trigger neutrophilia. For example, inflammation or injury may cause pain, but this cannot be attributed to the neutrophilia that then develops. Also, complaints and signs that may be associated with the multitude of other causative factors are neither caused nor exacerbated by the pathologically increased number of neutrophils.
Diagnosis and course of the disease
Because neutrophilia is completely asymptomatic, it is usually discovered more or less incidentally during laboratory blood testing. Routine determination of blood counts in the laboratory allows differentiation between the various leukocytes. A distinction is made between neutrophils, lymphocytes, monocytes, eosinophils and basophils, which perform different tasks within the immune system. The course of neutrophilia depends very much on the course of the causative factors.It may be self-regulating, as in the case of a stressful situation, or it may also regress on its own after overcoming a local or systemic infection, or, in the case of myeloid leukemia, it may take a serious course if left untreated.
Complications
In most cases, neutrophilia does not cause any particular symptoms or complications. However, in some cases, inflammation and infection may occur more quickly because of neutrophilia. The symptoms vary so that neutrophilia is diagnosed relatively late in most cases. However, neutrophilia does not have any negative health effect on the body of the affected person. In many cases, the complaint also disappears completely once the infection or inflammation is over. No special treatment is necessary in this case. However, neutrophilia can also occur as a result of leukemia, negatively affecting the quality of life. In this case it is possible to treat neutrophilia with the help of medications. However, complications do not occur even in this case. Neutrophilia also does not affect the patient’s life expectancy. As a rule, this disease cannot be prevented. However, hygiene measures should be observed, especially after surgical procedures, to avoid infections and inflammations.
When should you go to the doctor?
In most cases, a rapid increase in leukocytes in the blood that lasts for a short period of time indicates an immune reaction of the body or an assecretion of the stress hormone adrenaline, which initially does not require medical treatment, as the value will level off on its own. However, if neither an injury, an acute inflammation or an infection is the trigger for an increase in the leukocyte count, neutrophilia cannot be ruled out. Since neutrophilia in itself does not reveal any symptoms, it is usually only detected on the basis of other complaints in the blood count. A visit to the doctor should therefore always be advisable if the patient feels unwell, tired or listless over a longer period without any recognizable signs of illness. Since in most cases major injuries or infections drive the affected person to the doctor, the disease is usually diagnosed on the basis of a precautionary blood sample. In rare cases, neutrophilia is also associated with leukemia. In this case, the leukocytes themselves are the primary factor responsible for the disease based on genetic bone marrow changes, which requires immediate initiation of treatment.
Treatment and therapy
Treatment of neutrophilia is always guided by treatment of the underlying primary disease or in the abolition of possible exogenous factors. These include, for example, the administration of certain medications or lifestyle changes if, for example, smoking is a major trigger of neutrophilia. As a rule, after successful treatment of the underlying disease, the number of neutrophils and other leukocytes settles back into the normal range. This means that by eliminating the triggering factors, it is left to the immune system to restore normal conditions. Treatment aimed directly at reducing neutrophils without considering the causative factors does not exist and would not be useful. Only in the case of acute myeloid leukemia the situation is different. In this disease, which is triggered by genetic changes in the bone marrow, the extraordinary proliferation of leukocytes is itself the primary disease. Possible therapies are therefore aimed directly at reducing uncontrolled proliferation.
Outlook and prognosis
The prognosis of neutrophilia is often tied to the presenting cause of the disease. If external circumstances are responsible for the health impairments, the further course of the disease is considerably tied to the affected person’s will to change. Continuous stress and states of strong emotional strain lead to the physical irregularities. Even without medical treatment, the affected person should learn to deal with life developments and everyday challenges in a more relaxed manner. Numerous self-regulation techniques can already help to reduce stress and bring about relief from the symptoms.In many cases, cooperation with a psychotherapist is recommended, as the success of treatment is significantly improved here. Behavioral and cognitive techniques are learned to enable better handling of stressful situations. In the case of a physical irregularity, drug treatment is often initiated. In these cases, self-help options are not sufficient to achieve lasting improvement. Long-term therapy is needed for the organism to become regulated. Basically, the prognosis improves if the lifestyle of the affected person is optimized. Avoidance of harmful substances such as nicotine or alcohol has been shown to help alleviate symptoms. In addition, the consumption of medications should only take place in consultation with the attending physician. Otherwise, side effects may occur, leading to an increase in symptoms.
Prevention
Because of the many possible causative agents of neutrophilia, direct preventive measures that would prevent the onset of the disease are almost inconceivable. Indirect measures that result in a strengthening of the immune system lead in principle to the immune system’s ability to overcome most causative factors such as infections, surgery, and injuries on its own, and an intervening neutrophilia regresses on its own.
Follow-up
In most cases of neutrophilia, the measures and options for aftercare are very limited, so the affected person is definitely dependent on immediate medical treatment for this disease. The earlier the disease is recognized and treated, the better the further course of the disease usually is, so that the affected person should see a doctor already at the first symptoms and signs of the disease. Self-healing is usually not possible, so that a doctor should be consulted at the first signs of the disease. Most patients with neutrophilia are usually dependent on taking various medications. It is always important to ensure that the medication is taken regularly and in the correct dosage in order to alleviate the symptoms properly and permanently. In case of any uncertainties or questions, a doctor should be consulted first. During the treatment, regular checks and examinations by a doctor are usually very important in order to detect further damage to the internal organs. However, the further course of neutrophilia is strongly dependent on the time of diagnosis and also on the manifestation of the disease, so that a general prediction is not possible in this case.
What you can do yourself
Due to the variety of possible causes of neutrophilia, self-help approaches are less specific than broad. In addition to specialist treatment of the underlying condition, it is essential to support the body in the healing process. Anything that helps to strengthen the immune system in the process also helps to alleviate inflammatory processes in the body. The immune system can be strengthened in many ways: a balanced diet adapted to the individual’s age, energy requirements and state of health forms the basis of a balanced lifestyle. Since the body is weakened by the consumption of harmful substances such as nicotine and alcohol, it is important to reduce these or do without them altogether. In addition, stress is a negative factor influencing the immune system. If stress cannot be avoided, it is advisable to integrate a balance of exercise and relaxation into everyday life. Depending on the severity of the clinical picture, there are individual possibilities for implementation in terms of duration and intensity. Although the clinical picture of neutrophilia is so heterogeneous, there are indirect ways to support the healing process and alleviate symptoms in everyday life.
