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Q: What does a white blood cell count of 12.3 tell me, other than it is considered elevated and may be associated with a viral infection? I am unable to determine where 12.3 ranks when 4500 / 11,000 is considered adult average.
A: The term leucocytosis is defined to be an elevated white blood cell count, i.e., a white blood cell count over 10000 per cubic millimeter of blood. It should be noted that, in general, fluctuations as great as 3000 to 4000 white blood cells per cubic millimeter may occur during normal daily activities. In particular, during complete rest, a white blood cell count in the lower range of normal may be measured. This value is increased by usual activity, so that, in the afternoon, a white blood cell count in the upper range of normal is common. Furthermore, physiologic variations outside the normal range may also be sometimes observed in patients with no apparent disease. Approximately one half of the white blood cells in blood circulate freely, while the remaining may be found in a marginal pool in the blood vessels. These white blood cells may be recruited to the circulation by many stimuli. Examples of these possible stimuli include physiologic, pharmacologic, and pathologic stimuli. For example, use of steroids causes an elevation in the number of white blood cells.
An increase in the white blood cells is often associated with an infection. In particular, a bacterial infection is frequently characterized by a so called neutrophilic leucocytosis, i.e., not all white blood cells are equally elevated, but, rather, one type of white blood cells, the so called band neutrophils, are more elevated than another type, the so called segmented neutrophils. While a detailed list of diseases that cause an increase in the neutrophils is too long to present here, suffice it to say that, in addition to bacterial infections, intoxication due to physical or chemical agents, acute bleeding, disorders characterized by death of tissue, such as severe burns, major surgery, a heart attack, etc., may all present with an elevated white blood cell count due to an increase in the number of neutrophils. Viral infections, on the other hand, are frequently characterized by an increase in another type of white blood cells, the so called lymphocytes, rather than the neutrophils. An increase in another type of white blood blood cell, the so called monocyte, is also seen in a number of infections, such as tuberculosis, infections with Listeria, and other chronic infections, such as abscesses, syphilis, inflammation of the inner lining of the heart and heart valves, etc. Even very common disorders such as hay fever and asthma can lead to an increase in the white blood cell count. However, the white blood cell type which is this time increased is a type of white blood cell referred to as an eosinophil. Finally, of course, malignant disorders can also lead to an increase in the white blood cell count. These disorders, however, are typically also characterized by the presence of immature white blood cells in the blood.
Updated: 09/12/99
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