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Neutrophils are white blood cells (WBC) that move from the blood into the cells to kill invading bacteria and fungi. If neutrophil levels become too high, neutrophilia results. Neutrophilia is the most common form of leukocytosis - a condition involving an increased number of leukocytes in the blood. Absolute neutrophilia refers to the increase in the total number of leukocytes in the blood as well as an increased percentage of neutrophils. This results in a neutrophil count of over 8,000.
Neutrophils are produced in the bone marrow, released into the blood, circulate briefly, and migrate into tissue spaces and onto epithelial surfaces.
Causes & Development
Injury, bacterial invasion of tissue or other causes results in the production and release of colony-stimulating factors, which increase proliferation and maturation of neutrophilic precursor cells in the bone marrow.
Other mediators of inflammation stimulate bone marrow release and promote margination and adhesion of neutrophils to vascular endothelium at the site of inflammation. The time for production of new cells from the bone marrow is 4 to 6 days. Neutrophils circulate for about 10 hours and are then compartmentalized into a circulating neutrophil pool (CNP) and a marginal neutrophil pool (MNP). Neutrophils in the CNP circulate with other blood cells and are measured in the CBC. The MNP consists of neutrophils that are intermittently adherent to endothelium, especially in small veins and capillaries.
Movement of neutrophils into tissues occurs randomly and is a one-way process. Neutrophils are destroyed in the spleen, liver, and bone marrow. The number of circulating neutrophils are affected by the rate of bone marrow production and release, the rate of exchange between CNP and MNP, and the rate of migration into tissue. Neutrophilia results when the rate of marrow production and release increases, neutrophils move from the MNP into the CNP, or the tissue demand for neutrophils increases.
Among the causes of neutrophilia are infections (i.e. bacterial or fungal infections or tuberculosis), inflammatory diseases such as rheumatoid arthritis, and loss of blood cells through bleeding or hemolysis (destruction of blood cells). Other causes include cold, heat, exercise, seizures, pain, labor, surgery, panic, and rage. In addition, myeloproliferative disorders, causing proliferation of bone marrow cells, and cancer may also cause neutrophilia.
Fear, excitement, and vigorous exercise cause epinephrine release. Neutrophils demarginate from MNP into CNP, resulting in a transient (1 hour), mature neutrophilia.
Corticosteriods, whether from stress or when using drugs like prednisone, cause increased bone marrow release of mature neutrophils, movement into the CNP, and decreased tissue migration. An increase in white blood cells and neutrophilia occurs 4 to 8 hours after elevation of stress hormones or steroid use and return to normal 1 to 3 days after later. Lymphopenia can occur concurrently.
Inflammation, sepsis, necrosis, and immune-mediated disease can cause increased tissue demand and increased bone marrow release of segmented and band neutrophils. Leukocytosis (15,000 to 30,000), neutrophilia with a left shift (the ratio of neutrophils to lymphocytes is high), toxic neutrophils, lymphopenia, eosinopenia, and variable monocytosis are seen often at the same time. Surgical removal or drainage of a septic focus may increase neutrophilia.
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Signs, symptoms & indicators of Neutrophilia:
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GLOSSARY
Adrenaline (Epinephrin, Epinephrine)
A hormone secreted by the adrenal medulla that is released into the bloodstream in response to physical or mental stress, as from fear or injury. It initiates many bodily responses, including the stimulation of heart action and an increase in blood pressure, metabolic rate, and blood glucose concentration.
Bacteria (Bacterial, Bacterium)
Microscopic germs. Some bacteria are "harmful" and can cause disease, while other "friendly" bacteria protect the body from harmful invading organisms.
Cancer
Refers to the various types of malignant neoplasms that contain cells growing out of control and invading adjacent tissues, which may metastasize to distant tissues.
Complete Blood Count (CBC)
A set of measurements that are generally determined by specially designed machines that analyze the different components of blood in less than a minute. The values generally included are:- White blood cell count (WBC). The number of white blood cells in a volume of blood. Normal range varies slightly between laboratories but is generally between 4,300 and 10,800 cells per cubic millimeter. This can also be referred to as the leukocyte count and can be expressed in international units as 4.3 - 10.8 x 10^9 cells per liter.
- Automated white cell differential. A machine-generated percentage of the different types of white blood cells, usually split into granulocytes, lymphocytes, monocytes, eosinophils, and basophils.
- Red cell count (RBC). The number of red blood cells in a volume of blood. Normal range varies slightly between laboratories but is generally between 4.2 - 5.9 million cells per cubic millimeter. This can also be referred to as the erythrocyte count and can be expressed in international units as 4.2 - 5.9 x 10^12 cells per liter.
- Hemoglobin (Hb). The amount of hemoglobin in a volume of blood. Normal range for hemoglobin is different between the sexes and is approximately 13 - 18 gm/dl for men and 12 - 16 for women (international units 8.1 - 11.2 millimoles/liter for men, 7.4 - 9.9 for women).
- Hematocrit (Hct). The ratio of the volume of red cells to the volume of whole blood. Normal range for hematocrit is different between the sexes and is approximately 45 - 52% for men and 37 - 48% for women.
- Mean cell volume (MCV). The average volume of a red cell. This is a calculated value derived from the hematocrit and red cell count. Normal range is 86 - 98 femtoliters.
- Mean cell hemoglobin (MCH). The average amount of hemoglobin in the average red cell. This is a calculated value derived from the measurement of hemoglobin and the red cell count. Normal range is 27 - 32 picograms.
- Mean cell hemoglobin concentration (MCHC). The average concentration of hemoglobin in a given volume of red cells. This is a calculated volume derived from the hemoglobin measurement and the hematocrit. Normal range is 32 - 36%.
- Red cell distribution width (RDW). A measurement of the variability of red cell size. Higher numbers indicate greater variation in size. Normal range is 11 - 15.
- Platelet count. The number of platelets in a volume blood. Platelets play a vital role in blood clotting. Normal range varies slightly between laboratories but is in the range of 150,000 - 400,000 per cubic millimeter (150 - 400 x 10^9 per liter).
Endothelium (Endothelia, Endothelial, Endothelioid)
A thin layer of flat epithelial cells that lines serous cavities, lymph vessels, and blood vessels.
Epithelial
Referring to the cells that line and protect the external and internal surfaces of the body. Epithelial cells form epithelial tissues such as skin and mucous membranes.
Hemolysis
The breakdown of old red blood cells into recycleable constituents, with particular importance given to the reuse of the heme part of hemoglobin.
Hormones (Hormone)
Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.
Leukocyte (Leukocytes)
A white blood cell which appears 5,000 to 10,000 times in each cubic millimeter of normal human blood. Among the most important functions are destroying bacteria, fungi and viruses and rendering harmless poisonous substances that may result from allergic reactions and cell injury.
Leukocytosis
Having abnormally high numbers of white blood cells, usually the result of a non-viral infection.
Liver (Hepatic)
The largest and one of the most complex organs of the body, the liver is responsible for much of the metabolism of fats, proteins and carbohydrates. It is the site of much of the body's detoxification. It is connected very closely with digestion and the regulation of blood sugar, among many other functions. Found behind the ribs on the right side of the abdomen, it has many important functions such as removing harmful material from the blood, making enzymes and bile that help digest food, and converting food into substances needed for life and growth. Hepatic: Pertaining to the liver.
Mediator (Mediate, Mediates, Mediators)
A substance or structure that helps bring about a specific response in a bodily tissue.
Necrosis
Death of one or more cells, or of a portion of a tissue or organ.
Neutrophils (Neutrophil)
Another name for polymorphonuclear leukocytes, the most common type of blood-carried white blood cell, and the first mobile resistance cell to come to the rescue in injury.
Precursor (Precursors)
A biochemical substance, such as an intermediate compound in a chain of enzymatic reactions, from which a more stable or definitive product is formed.
Rheumatoid Arthritis
A long-term, destructive connective tissue disease that results from the body rejecting its own tissue cells (autoimmune reaction).
Seizure (Seizures)
While there are over 40 types of seizure, most are classed as either partial seizures which occur when the excessive electrical activity in the brain is limited to one area or generalized seizures which occur when the excessive electrical activity in the brain encompasses the entire organ. Although there is a wide range of signs, they mainly include such things as falling to the ground; muscle stiffening; jerking and twitching; loss of consciousness; an empty stare; rapid chewing/blinking/breathing. Usually lasting from between a couple of seconds and several minutes, recovery may be immediate or take up to several days.
Sepsis (Blood Poisoning, Septicemia)
Like septicemia, an infection that has moved deeply into the body, involving the subcutaneous or submucosal layers, connective tissue, lymph system, or blood. Septicemia: The presence of pathogenic bacteria or other microbes in the blood stream - a serious business, since most defenses are focused outside the bloodstream and the infection has bypassed them either due to its virulence, the depth and severity of the original focal infection or the weakened state of the body's immunity and life energy. Blood poisoning.
Spleen (Splenectomy)
The largest organ of the lymphatic system in the body, located between the stomach and the diaphragm (the muscle below the lungs which provides the motion for breathing). It destroys old red blood cells, produces lymphocytes and plasma cells, and stores blood. It also has other as yet unknown functions. A splenectomy is the surgical removal of the spleen.
Steroid (Steroids)
Any of a large number of hormonal substances with a similar basic chemical structure containing a 17-carbon 14-ring system and including the sterols and various hormones and glycosides.
Tuberculosis
Also known as TB, Consumption or "The White Plague", tuberculosis is an infectious disease caused by a bacterium called Mycobacterium tuberculosis, usually affecting the lungs but possibly also the brain, kidneys and bones. Patients may at first be symptom-free or experience a flu-like illness. In the secondary stage, there might be a slight fever, night sweats, weight loss, fatigue and various other symptoms, depending on the part of the body affected. Tuberculosis of the lung is usually associated with a dry cough that eventually leads to a productive cough with blood-stained sputum. There might also be chest pain and shortness of breath.
Vascular
Relating to the blood vessels of the body. The blood vessels of the body, as a group, are referred to as the vascular system. They are composed of arteries, veins and capillaries - arteries that pass oxygen-rich blood to the tissues of the body; veins which return oxygen-depleted blood from the tissues to the lungs for oxygen; and the capillaries that are the tiniest vessels and are between the arteries and veins.
White Blood Cell (WBC, White Blood Cells)
A blood cell that does not contain hemoglobin: a blood corpuscle responsible for maintaining the body's immune surveillance system against invasion by foreign substances such as viruses or bacteria. White cells become specifically programmed against foreign invaders and work to inactivate and rid the body of a foreign substance. White blood cells are composed primarily of neutrophils, monocytes and lymphocytes. Lymphocytes are either T-cells or B-cells. T-cells (CD3 cells) are divided into T-helper (CD4 cells) and T-suppressor/cytotoxic (CD8 cells) cells.
Last updated: Jun 28, 2008
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