Increased content of granulocytes. Granulocytes are lowered: what to do. Decreased neutrophilic leukocytes against the background of elevated lymphocytes

Granulocytes or polymorphonuclear blood cells are called a special kind of leukocytes (white blood cells) that provide protective functions of the body. A blood test for granulocytes is the simplest and fastest way to diagnose pathological conditions. Granulocytes can be increased, decreased in.

Granulocytes come from the specifics of their structure: granular cells with two nuclei inside. Polymorphonuclear cells are divided into three groups: basophils, neutrophils and eosinophils, each of which performs its own functions. So, they are responsible for the regulation of immune processes, preventing the spread of infection throughout the organ or the body as a whole. Before doing a blood test for granulocytes, we will analyze their composition.

They contribute to the removal of various poisons from the body, participate in the development of allergic reactions, are responsible for the appearance of new capillaries and provide an acceleration of the suppression of allergens. produce enzymes that are responsible for bactericidal functions.

Granulocytes in the blood are produced by the bone marrow. Granular leukocytes have a short life cycle: after leaving the blood, in which they live for about a week, they stay in the tissue for about two days.

Thus, it has a high diagnostic potential for detecting pathological disorders in the functioning of the body or for clarifying various inflammatory processes occurring in it.

Norm

As with any indicator, normative values ​​are set, deviations from which allow one to judge the ongoing changes. The level and norm of granulocytes is estimated by quantitative and qualitative parameters and is expressed as a percentage of the total number of leukocytes.

In a blood test for granulocytes, the norm of the content of the absolute amount varies within the range from 1.1 to 6.7 × 10⁹/l. For newborns, acceptable values ​​​​are in the range from 5.5 to 12.5x10⁹ / l. The rate of granulocytes in the blood for children under the age of twelve is 4.5 - 10.0x10⁹ / l .; for adolescents of the pubertal period - 4.3 - 9.5x10⁹ / l.

The relative content of granular leukocytes ranges from 44% to 71%. This applies to mature cells, but the level of young cells is also studied. A variant of the norm of granulocytes in the blood is considered if from 1 to 5% of young neutrophils, eosinophils and basophils are found in the blood.

A change in the level of mature, both up and down in relation to the normative value, is evidence of the presence of deviations in the state of the body.

In some cases, a deeper study of the level of content of polymorphonuclear cells is carried out, in this case, the content of cells by groups becomes the subject of analysis.

Neutrophils in the blood exist in two forms: rod-shaped and segmented. The norm of rod-shaped neutrophils is considered to be 1-5.9% of the total number of leukocytes and in the range of 45-72%.

For eosinophils, the content in the blood in the range of 0.5-5% corresponds to the norm, for basophils - within 1%.

Promotion and demotion

According to studies, deviations in the content of cells in the blood from the norm can be presented in two varieties: when, according to a blood test, granulocytes are lowered or when, according to a blood test, granulocytes are increased.

Exceeding the norm of the content of immature granulocytes in the blood is also evidence of trouble in the body. Most often, an increase in young granulocyte cells in the blood is due to the presence of acute and chronic diseases (tuberculosis, pyelonephritis, influenza, psoriasis, cholera, rubella). With burns, acute bleeding, and poisoning with chemicals, there is also an increase in granulocytes in the blood.

The reasons for the increase in the level of granulocytes in the blood can be associated with the peculiarities of the physiological state of the body, these include childbirth, pregnancy, lactating mothers also have an increased level of these cells, they also provoke excess values ​​of physical activity or abundant nutrition. In women, an increase in the level of granulocytes in the blood is observed regularly before critical days.

These changes can be recognized as a physiological norm, provided that the level of cells remains constant.

Autoimmune diseases such as rheumatism, scarlet fever, tumor, sarcoidosis can cause a low level and decrease in granulocytes in the blood.

In some cases, the level of deviations of granulocytes from the norm for groups of granular leukocytes is examined:

Granulocytes- leukocytes, which inside contain granularity, consisting of small parts filled with active ingredients. They appear in the bone marrow from the corresponding germ. Presented as three main types: basophils, neutrophils and eosinophils. To determine the indicators, appropriate analyzes are given. If the granulocytes are lowered, this may mean that a virus is spreading in the body, or there are blood pathologies. In any case, all this requires the appointment of special therapy.

Granulocytes in the blood are lowered - what does this mean?

Typically, such test results indicate autoimmune ailments. Often, the cause can be safely considered a decrease in the number of eosinophils, which reduces the effectiveness of the immune system. This usually happens with some diseases:

• diabetes;
• tuberculosis;
• rheumatism;
• hepatitis;
• leukemia;
• anemia.

Sometimes reduced results can be associated with taking certain medications - antibiotics, sulfonamides, and anticancer drugs.

Granulocytes are leukocytes that contain granularity in their composition - small granules filled with active biological substances. They are formed in the bone marrow from the granulocyte germ of hematopoiesis and are represented by three types of cells: neutrophils, eosinophils, basophils. The content of leukocytes is determined by studying the general blood test, which belongs to the most common laboratory analysis in medical practice. In the results of the study, low granulocytes are often found, which indicates a pathological process in the body and requires the appointment of a specific treatment.

Neutrophils

Neutrophilic granulocytes represent the most numerous group and make up 45-75% of the total number of white blood cells. In the peripheral blood of a healthy person, segmented and stab forms are found. Segmented granulocytes have a large amount of cytoplasm and a small nucleus, which is divided into 5-6 segments. Band granulocytes are younger forms of leukocytes with a horseshoe or S-shaped nucleus, their number is not more than 6%. In the blood of a child in the first year of life, the content of leukocytes with a stab nucleus can reach 20%, which is a physiological variant of the norm. With age, the number of sticks gradually decreases.

The main function of cells is the process of phagocytosis - the search, capture and digestion of foreign agents (bacteria, tumors, viruses, protozoa). Numerous granules in the composition of neutrophils contain hydrolase, myelopyroxidase, lysozyme, which destroy pathogenic particles and are an important link in cellular immunity. As a result, pus is formed at the site of inflammation, consisting of destroyed tissue cells, granulocytes, infectious agents, and inflammatory fluid.

View of neutrophils under a microscope

A decrease in the concentration of blood neutrophils is called neutropenia (less than 1.7 * 109 / l) and occurs in the following cases:

An infant may experience congenital neutropenia - Kostman's syndrome, which is a disease with an autosomal recessive inheritance mechanism. As a result of insufficient formation of neutrophils in the bone marrow, chronic foci of infection develop on the skin and in internal organs, which can be fatal due to insufficient cellular immunity.

Eosinophils

View of eosinophils under a microscope

The reduced content of eosinophils is called eosinopenia (less than 0.05 * 109 / l) and manifests itself in the following cases:

• taking glucocorticoids;
• acute course of infections, mainly of a bacterial nature (paratyphoid, typhoid, tularemia);
• physical stress;
• prolonged stressful situations;
• septic condition;
• surgical interventions;
• extensive burns;
• polytrauma;
• aplastic processes in the bone marrow;
• anemia associated with folic acid deficiency.

Low levels of eosinophils occur in the case of a severe course of the pathology, especially in a child, which is associated with the imperfection of the hematopoietic process in early childhood.

Basophils

Basophilic granulocytes are small cells with a small amount of cytoplasm and a large nucleus divided into 2-3 segments. Getting into the peripheral blood from the hematopoietic organ, they circulate for 3-4 hours, after which they move to tissues with a predominantly allergic nature of inflammation. Basophils take part in anaphylactic-type reactions and indirectly in delayed-type reactions when interacting with lymphocytes. In the pathological focus, they secrete biologically active components - inflammatory mediators: histamine, serotonin, heparin. The life cycle of cells is 9-12 days, their content in the blood is insignificant and amounts to 0.5% of the total number of white blood cells.

View of a basophil under a microscope

The reasons for the decrease in the number of basophils - basopenia (less than 0.01 * 109 / l) - include:

• stressful situations;
• pneumonia;
• acute infectious diseases;
• pathology of the thyroid gland with an increase in functional activity (hyperthyroidism, Basedow's disease);
• Cushing's syndrome;
• taking hormonal anti-inflammatory drugs (hydrocortisone);
• period of gestation and ovulation.

Lowered basophils are quite rare and indicate severe inhibition of hematopoietic function.

A decrease in granulocytes in the general blood test appears with the development of a pathological process in the body, which means that it requires additional diagnostic examination and the appointment of complex therapy for the disease that led to a change in the content of cells.

In this article, we will tell you what GRA (Gran) is, what is the level of granulocytes in normal and pathological conditions, and what they are.

Often, when patients receive forms in their hands, they see unfamiliar abbreviations there: , MCH, MCHC, GRA (gran) in a blood test - what is it? Unable to figure it out on their own, they ask the doctor to explain in general, but doctors, as a rule, have no time.

But in order to "reach" granulocytes, you need to understand that this is the term "level 4", if we consider whole blood. First, the blood is separated by centrifugation into plasma and into formed elements. Among the formed elements, erythrocytes, or red blood cells, are distinguished, which carry oxygen and perform the function of gas exchange. They secrete white blood cells, or leukocytes, whose function is protective. The third group of blood cells are platelets, or platelets, which are required when bleeding occurs. Their main function is thrombosis and blood clotting.

And, just starting to consider leukocytes and their varieties, we meet with granulocytes and agranulocytes. If we take a standard complete blood count, the doctor rarely considers the number of granulocytes as a separate diagnostic sign. For him, the overall level of leukocytes is much more important, and their "national composition", or the relative, percentage of varieties within the group of granulocytes.

Granulocytes and agranulocytes

Once upon a time, in the last century, there were manual methods for counting blood cells, and there were no modern biochemical and hematological analyzers. And there was no such thing as gra in a blood test. It's just that no machine has yet been created that dispenses a check with the encoded names of blood cells and their groups. There were granulocytes, and even a specialist could not immediately say what GRA is in a blood test.

Currently, all modern laboratories are large automated complexes, and the decoding of a blood test is carried out without human intervention. And if values ​​are obtained that differ from the reference ones (limits of the norm), then they are rechecked manually.

Consider the functions of granulocytes in comparison with other blood cells, and some reasons for the deviation from the norm of their total number.

Granulocytes is a collective term. All of them are leukocytes, but, in addition to granulocytes, leukocytes also include monocytes and lymphocytes, in the cytoplasm of which there are no granules. If we consider only granulocytes from leukocytes, then they are different - these are cells of the immune system that “live” in the blood and perform different functions. All of them provide:

• recognition and destruction of foreign bacteria and foreign components in general;
• they eliminate the old cells of their own organism and destroy them;
• they produce immune responses and are responsible for inflammation;
• granulocytes are the basis of the body's antibacterial defense and the substrate of allergic manifestations.

On average, a healthy adult has between 4,500 and 11,000 white blood cells per microliter (µL) of blood. This includes both granulocytes (basophils, eosinophils, neutrophils) and agranulocytes (monocytes and lymphocytes).

The norm of lymphocytes is up to 40% of the total number of leukocytes, and monocytes up to 10% of all leukocytes. These cells are agranulocytes, that is, in their cytoplasm there are no specific inclusions or granules characteristic of granulocytes. Therefore, we can safely assume that half of all leukocytes of the human body belong to granulocytes, and their average number is 6-7 thousand cells per microliter of blood.

There are no exact values, and this range is approximate, since the internal structure of this group is very variable, and reacts with an increase or decrease in different types of blood cells to different stimuli.

The norm of GRA in a blood test and possible deviations

Let us consider why the total number of basophils, neutrophils and eosinophils can decrease or increase in the peripheral blood of a person, that is, why “lowered” granulocytes or their increased number appear.

In a healthy person

The main deviations of granulocyte parameters can be both physiological and pathological. Physiological or "normal" elevations can and do occur regularly after large meals and after exercise. That is why a complete blood count should be taken on an empty stomach, and at the same time early in the morning.

Relative leukocytosis also occurs on the background of stress. The female body is preparing for menstruation, and during menstruation the number of granulocytes in the blood increases, just like in the second half of pregnancy and at a dangerous time for the immune system - during childbirth.

There is no physiological decrease in the number of granulocytes in nature. Perhaps, after menstruation, there is some decrease in them in the peripheral blood, but too insignificant to be seen in each case.

Increase and decrease in granulocytes in pathology

Most often, the number of leukocytes in general and granulocytes in particular increases with:

• inflammatory processes that proceed according to the classical pattern with redness, swelling, heat and soreness of the affected tissues;
• against the background of infectious diseases, both bacterial and;
• in the presence of chronic diseases and endotoxicosis (with severe diabetes, chronic renal failure and uremia, with gout);
• with injuries, various types of shock and burn disease;
• granulocytes and leukocytes react by leaving the depot during bleeding, and during various operations.

Tumor leukocytosis is a diagnostic feature: it occurs against the background of a blood disease, and occurs in lymphoproliferative diseases.

Much more common in clinical practice is leukopenia, or a decrease in the relative number of granulocytes and leukocytes. Most often, their number decreases:

• against the background of viral infections, in contrast to microbial;
• with rheumatic lesions - systemic lupus erythematosus and rheumatoid arthritis, with other diseases of the connective tissue;
• while taking various medications - NSAIDs, cytostatics, thyroid hormone blockers, some analgesics, chloramphenicol and sulfonamides.

There is a pronounced decrease in granulocytes in hypoplastic and aplastic anemia, in bone marrow tumors, against the background of anaphylactic shock and in some rare diseases. Their level drops sharply with radiation sickness, as well as with splenomegaly, or with an enlarged spleen. It is known that the spleen is a graveyard of erythrocytes, and destroys many blood cells, including many types of granulocytes.

Types of granulocytes in the human body and their functions

Basophils in the blood of children and adults are the smallest population of blood cells. They are only half a percent, rarely 1%. In the blood, basophils live for about 6 hours, and then they move into the tissues, and die after two days. They are responsible for the course of allergic diseases, and are able to phagocytize foreign particles. They are called basophils for the content of granules of acidic proteins, which are stained with basic dyes and turn blue.

Normally, their number does not exceed 1%, and basophils can increase with chickenpox, the introduction of foreign proteins, with chronic hemolytic anemia, after removal of the spleen, and also with chronic myeloid leukemia. This process in the body is a kind of eosinophilic-basophilic association. An increase in basophils is often observed with endocrine pathology, for example, with hypothyroidism, or hypofunction of the thyroid gland.

Eosinophils

All parents know about these blood cells that eosinophils are responsible for allergic reactions. If the child's skin itches, an allergic rash appears, then the level of eosinophils also rises. The number of diseases in which the content of this type of granulocytes in the blood increases is quite large:

• it is hay fever and bronchial asthma;
• eczema and food allergies;
• allergy to medication;
• various types of dermatitis.

A careful interpretation of the general blood test in acute myocardial infarction may also indicate massive necrosis of the heart muscle, which is manifested by eosinophils, and this is an unfavorable sign. As for eosinopenia, or a decrease in values, this most often occurs with severe purulent infections, and against the background of severe stress. Normally, the number of eosinophils does not exceed 1 - 5% of all leukocytes.

Read more about eosinophils in our articles:

Neutrophils

If basophils were the rarest guests in human blood, then neutrophils are the most numerous order of granulocytes. And when they talk about gran (GRA) indicators in blood tests, they most often mean these cells. Their granules are stained with neutral dyes. Their changes in the blood say a lot about the state of human health. What can be learned from the results of a complete blood count?

Normally, neutrophils make up half of all leukocytes, and in an adult they range from 47% to 72%. Depending on the degree of maturity, they distinguish which are younger and or mature.

What are granulocytes and their functions

Granulocytes or granular white blood cells are the body's first line of defense against germs. These cells are the first to reach the lesion, and also participate in the appearance of cellular immunity.

Granulocytes include eosinophils, basophils and neutrophils, as well as their young forms - stab and young. All these types of leukocytes have special granules in the cytoplasm, which can be stained with both acidic and basic dyes.

Normally, a person also contains varieties of leukocytes that do not contain granules. Their function is associated with the formation of antibodies, these are monocytes and lymphocytes.

Myeloblasts, stem cells, are the progenitors of granulocytes, which can be mature or immature. What are immature granulocytes? These are the cells that are not fully formed and have not acquired the necessary functions characteristic of mature cells.

The most important functions of these granulocytes are to capture and neutralize foreign cells, including the neutralization of bacterial pathogenicity factors and antigens. The bone marrow is where granulocytes are formed. All granular cells penetrate into human tissue, where they subsequently perform their duties.

The granulocyte nucleus has an irregular shape with a division in the form of lobules, the number of which is from two to five, in connection with this, these cells can also be called polymorphic, that is, consisting of many nuclei. Thus, granulocytes can include cells such as eosinophils, basophils, neutrophils, which make up up to 70% of the total number of leukocytes that are in human blood. Each type of granulocyte is responsible for a certain type of inflammation in the body, in which they play a leading role in the fight. Nevertheless, they work together with all representatives of the series, for example, macrophages and neutrophils often react, as well as basophils with eosinophils, due to a certain similarity between them.

Immature granulocytes cannot be seen in the blood of a healthy person, since they do not go beyond the bone marrow - only mature forms circulate in the blood. However, during an emergency, there is a lack of fighting cells. In this situation, it is young or immature granulocytes that save, which can later be seen in the results of a blood test.

Young granulocytes are not whimsical. They function perfectly in inflamed tissues, where there is a lack of blood and, as a result, oxygen, while “feeding” on the energy produced by anaerobic glycolysis.

The lifespan of immature granulocytes ranges from a few days to a maximum of ten days (type and condition play a role here), which differs significantly from leukocytes that protect the body, which can live for years after they have “met” with a foreign protein - this is necessary in order to confront him in the future. But granulocytes in the blood do not have such a memory, because after performing the function they die and are replaced by new "fighters".

Normal value of granulocytes

The normal granulocyte count is abbreviated as a percentage of the total white blood cell count.

A normal indicator is considered to be 1.2 - 6.8 * 10⁹ l / blood GRA 47 - 72% of the total level of leukocytes.

The study also indicates the level of immature granulocytes. The rate of granulocytes can vary from one to five percent.

The quantitative content of granulocytes is determined by a general blood test, in which the relative and absolute number of these cells is calculated.

Both in men and women, the normal level of granulocytes is in the range of 1.2 - 6.8X10⁹ per 1 liter of blood. The relative number of contained cells is - from 47 - 72%.

Often during gestation, granulocytes are elevated, which is normal, but if the level is constantly elevated, then pathology may develop.

A child under 12 years old may have other indicators that differ from the norm. Especially if we talk about the percentage of certain species. Upon reaching an older age, the indicators become, as in an adult.

Immature granulocytes are increased

With an increase in neutrophils, often the leukocyte formula tends to shift to the left. Thus, we can talk about the presence of immature and stab granulocytes. This means that a pathological inflammatory process develops in the body. In this regard, the production of these white blood cells begins in the required volumes in order to protect a person from infections. Therefore, it can be observed from the analyzes that immature granulocytes are increased. Their level also increases during physiological processes:

During pregnancy;

in stressful situations;

After eating food;

During physical activity.

If a child in infancy has an increased level of granulocytes in the blood, then you should not panic, as this is the norm.

Increased values ​​of young granulocytes can be observed if the following pathological conditions are present:

Inflammation of the lungs, appendicitis, purulent-necrotic processes in the bones, inflammation of the meninges, kidney disease, cholera, sepsis, tonsillitis, thrombophlebitis, cholecystitis, scarlet fever, otitis media;

Purulent processes: abscess and phlegmon;

Typhoid fever, tuberculosis, hepatitis, malaria, measles, influenza, rubella;

Chronic skin diseases: psoriasis, some types of dermatitis;

Acute bleeding;

Intoxication of various etiologies: lead poisoning, mosquito bites, etc.;

Malignant formations;

Systemic diseases;

Gout;

Myocardial infarction, pulmonary infarction;

Gangrene;

Chronic myeloplastic diseases;

serum sickness;

After using certain medications.

The sharpest shift to the left can be observed in the development of myelomonocytic leukemia and purulent process. You can also observe changes in the qualitative plan, often with intoxication, purulent and inflammatory lesions, however, with a stroke, burn, heart attack and trophic ulcer, neutrophils rarely increase. Thus, high rates should be alarming.

Granulocytes are lowered

If the granulocytes are lowered, then this indicates problems in the functioning of the immune system. It is necessary to find out, with a complete study, which type of granulocytes is reduced, since this gives very important information. For example, the level of neutrophilic granulocytes decreases when:

Typhoid fever;

radiation sickness;

Malaria;

Primary myelofibrosis and;

Iron deficiency and aplastic anemia;

Hepatitis;

rubella;

Tularemia and brucellosis;

Lupus erythematosus, collagenosis;

Enlarged spleen;

cachexia, alcoholism;

Treatment with drugs: antibiotics, antiviral, psychotropic, antihistamines, anticonvulsants, non-steroidal anti-inflammatory drugs.

The decrease in granulocytes in infants often develops against the background of hereditary neutropenia. Its manifestations are due to the presence of skin infectious rashes. If the value is less than 0.05 * 109 / l, we can talk about a reduced level of eosinophils. This condition is called eosinopenia. It appears in the background:

Taking glucocorticoids;

Acute course of infection, with a bacterial character;