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Leukocytosis

Leukocytosis is an increase in the number of leukocytes in the blood of more than 8000-9000 in 1 mm 3 ; hyperleukocytosis - more than 40,000–50,000 in 1 mm 3 . Leukocytosis occurs as a result of increased leukopoiesis or from the redistribution of leukocytes in the body. There are physiological and pathological leukocytosis. The physiological leukocytosis includes digestive (coming after eating), muscular (after physical exertion), leukocytosis of newborns , pregnant women, and leukocytosis from cooling. Pathological leukocytosis occurs as a reaction of the blood-forming organs to irritation caused by infectious, toxic, inflammatory, radiation and other agents. Leukocytosis is also observed with tissue necrosis (myocardial infarction, tumor collapse), after major blood loss, injuries, brain injuries, etc. Leukocytosis, as a rule, is a transient phenomenon, it disappears along with the cause. Temporarily advancing leukocytosis with the appearance of immature forms in the blood is referred to as leukemoid reaction (see), a persistent similar blood picture is observed in leukemia (see). In most cases, leukocytosis occurs an increase in the number of neutrophils - neutrophilic leukocytosis, often with a shift to the left (see leukocyte formula ). Eosinophilic leukocytosis (see Eosinophilia ) accompanies many allergic conditions (bronchial asthma, serum sickness ), helminthic invasions, pruritic dermatosis , etc. Lymphocytosis is noted in some infections and intoxications. Monocytosis occurs with septic endocarditis , malaria, rubella, mumps , syphilis, etc.

Leukocytosis is an increase in the total number (or individual forms) of leukocytes in peripheral blood under physiological conditions and pathological processes.

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Leukocytosis is temporary and disappears along with the cause of it. The normal number of leukocytes in the blood is 6,000–8,000 per 1 mm 3 with extreme fluctuations from 4,000 to 9,000 per 1 mm 3 . In healthy people during the day the number of leukocytes is not constant, it varies within the physiological norm. In addition, the average error in the calculation of leukocytes is 7%. An increase in the number of leukocytes to 40,000–50,000 and above is called hyperleukocytosis. Leukocytes are normally unevenly distributed in the bloodstream of various organs and systems. It has been established that their content is much greater in the liver, spleen, and also in the central vessels in comparison with the vessels of the skin. Leukocytosis can occur as a result of the redistribution of leukocytes in various vascular areas, their mobilization from the depot (redistributive, or neurohumoral, leukocytosis), during the stimulation of the bone marrow by pathological agents, leukocytosis increased with the appearance of young leukocytes in the blood (absolute, or true, leukocytosis). Both true and redistributive leukocytosis can be observed simultaneously. The tone of the vessels matters: their expansion and slowing down of the blood flow is accompanied by the accumulation of leukocytes, the narrowing - the decrease in their number. There are physiological and pathological leukocytosis.

Physiological leukocytosis, mostly redistributive, transient, is observed during pregnancy (especially in late periods), during childbirth and in newborns, during muscular tension (in athletes, in children after screaming) - myogenic leukocytosis; with a rapid transition from a vertical to a horizontal position - static leukocytosis; after a cold shower or bath. Digestive leukocytosis occurs 2-3 hours after a meal, especially protein; it is often preceded by leukopenia. In the development of this type of leukocytosis, conditioned-reflex reactions matter: leukocytosis can be observed at the mention of food, by the time of habitual food intake. Mental excitement can lead to leukocytosis.

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Pathological leukocytosis is observed in many infectious diseases, inflammatory processes, especially purulent, toxic effects, under the influence of ionizing radiation (very briefly), with injuries to the skull, brain concussion, hemorrhages in the brain, after surgery, with shock (traumatic leukocytosis). These include toxic leukocytosis observed in case of poisoning (arsenic, mercury, carbon monoxide, acids), tissue decay, necrosis due to impaired local blood circulation (gangrene of the extremities, infarctions of internal organs, malignant neoplasms with decay), as well as leukocytosis of the uremic, medicament Collargol, antipyrine), adrenaline (irritation of the sympathetic nerve). Post-hemorrhagic leukocytosis occurs after heavy hemorrhages (irritation of the bone marrow by blood decay products). High degrees of leukocytosis with a significant rejuvenation of leukocytes occur with leukemoid reactions, especially with leukemia. In some diseases (appendicitis, lobar pneumonia, angina pectoris), an increase in the number of leukocytes in the blood taken from the skin over the affected organ was noted - local leukocytosis.

Pathological leukocytosis is most often neutrophilic (neutrophilia) and is often accompanied by qualitative changes in neutrophils ("nuclear shift"). The severity of leukocytosis during infection depends on its severity, nature and reactivity of the organism. In young people, the reaction of the hematopoietic tissue is more pronounced, and in the elderly it is often absent. In addition to neutrophilic leukocytosis, there are leukocytosis, depending on the increase in the number of other types of leukocytes.

Eosinophilic leukocytosis (eosinophilia) often proceeds without an increase in the total number of leukocytes. Eosinophilia observed in allergic conditions (asthma, angioedema, intolerance to drugs, such as penicillin, and the like. D.), Helminthiasis (ascariasis, echinococcosis, trichinosis), and scarlet fever, periarteritis nodosa, hemorrhagic vasculitis, rheumatism, syphilis, tuberculosis, lymphogranulomatosis. The appearance of eosinophilia in acute infectious diseases in the period of subsidence of fever is regarded as a favorable prognostic sign.

Basophilic leukocytosis is rarely observed, for example, when injecting foreign protein (vaccinations), hemophilia, hemolytic anemia, leukemia.

Marked types of leukocytosis occurring with an increase in granulocytes, can be considered as granulocytosis. There may also be an increase in blood lymphocytes (lymphocytosis) and monocytes (monocytosis). Monocytosis is noted in infections (typhus, malaria, smallpox, measles, epidemic parotitis, syphilis), protozoal diseases, prolonged septic endocarditis, and chroniosepsis.

Pathological leukocytosis has a certain diagnostic and prognostic value, in particular for the differential diagnosis of a number of infectious diseases and various inflammatory processes, assessment of the severity of the disease, reactive ability of the body, the effectiveness of therapy. This should take into account the increase in the number of leukocytes of certain species, the qualitative features of neutrophils ("nuclear shift") and the clinical picture of the disease as a whole.