High lymphocytes in the blood causes. Lymphocytes are increased. What does this indicate? What to do if lymphocytes are increased in the child’s blood

Lymphocytes are a type of leukocyte - white blood cells. They perform an immune function. Lymphocytes are one of the main cells of the immune system, like monocytes and neutrophils, which are responsible for the production of antibodies - molecules aimed at destroying foreign particles and removing them from the body. If they are decreased or increased, then such data indicate that a malfunction has occurred in the body. The first phenomenon is called lymphopenia, the second - lymphocytosis. Normally, the level of these cells in the blood can change during the day, under the influence of various internal/external factors (stress, temperature changes, premenstrual syndrome, etc.). However, further diagnosis is absolutely necessary if lymphocytes are elevated. Lymphocytosis is an increase in lymphocytes relative to normal. Depending on age, the following normative indicators are identified:

Content of lymphocytes in the blood, normal

When lymphocytes are elevated

An increased level of lymphocytes in the blood is determined by a general blood test. There are 2 types of lymphocytosis: absolute and relative. In the first case, all types of leukocytes are increased, in the second - only lymphocytes (the indicators of other white blood cells are decreased: segmented neutrophils, monocytes, etc.). To determine the ratio of different types of leukocytes in the blood during analysis, a special leukocyte formula is used.

Causes of lymphocytosis

Why is it only through analysis that we can find out about changes in the number of blood cells? Lymphocytosis has no specific symptoms - only a general blood test can determine it. The result is deciphered by specialists from biochemical laboratories, and on its basis, as well as based on medical history data or the nature of the patient’s complaints, the doctor can put forward a hypothesis about the reasons for the increase and prescribe further examination. An increase in lymphocyte levels can be caused by a number of factors that are specific to adults and children.

In children

An increased number of lymphocytes in children can be caused by:

1. Viral diseases: lichen, whooping cough, malaria, varicella (chickenpox), measles, viral hepatitis and others;
2. Infection: influenza, ARVI, sore throat and others;
3. Purulent-inflammatory processes;
4. Bronchial asthma;
5. Leukemia

Lymphocytes can also be elevated during other diseases, with various individual characteristics of the body. The exact reasons can only be determined after a full examination. It should also be remembered that sometimes lymphocytes remain elevated even some time after recovery in a blood test.

If lymphocytes are elevated in adults

An increase in lymphocytes detected in the analysis of an adult may be due to:

1. Various diseases of an infectious viral nature: all kinds of colds, flu, ARVI, hepatitis, mononucleosis and others;
2. Systemic blood disease: lymphosarcoma, leukemia, lymphocytic leukemia and others;
3. Bronchial asthma;
4. Serum sickness;
5. Various diseases of the endocrine system: thyrotoxicosis, Addison's disease, acromegaly and others;
6. Hypersensitivity to certain drugs;
7. Neurasthenia;
8. Vasculitis;
9. The recovery period after an illness;
10. Poisoning with dangerous chemicals: arsenic, lead and others.

The number of lymphocytes deviating from the norm may be evidence of the presence of other diseases - in each case it is individual. Deciphering a blood test is not a sufficient basis for making a particular diagnosis - such a conclusion can only be given based on the results of a full examination by qualified doctors. It should also be remembered that if monocytes and other types of leukocytes are low, then this may also indicate that lymphocytes are high . In each specific case, if a disease is suspected, a detailed breakdown of all indicators should be carried out.

Lymphocytosis in pregnant women

The number of white blood cells (lymphocytes, monocytes, etc.) is a very important indicator during pregnancy. Why are gynecologists watching him so closely? The reasons for this are that normally the body maintains a level of leukocytes that is safe for the fetus, that is, lymphocytes carry out their functions and do not pose a threat of destruction to foreign antigens of the father, which the embryo must have. If lymphocytes are elevated, then this situation can cause a miscarriage. Therefore, pregnant women need to closely monitor the level of lymphocytes and other leukocytes. Regular blood tests will help with this. This is especially necessary in the 2nd and 3rd trimester of pregnancy. You will also need to see a doctor if your white blood cells are low.

Treatment

Lymphocytosis is not an independent disease. If lymphocytes are higher than normal, this means that some pathological processes are occurring in the body. To eliminate them, you need to:

• Identify the reasons. For this, a comprehensive examination is prescribed. Consult a specialist. Deciphering the data of any tests and studies should be carried out only by an experienced doctor.
• Get treatment. Specific prescriptions are given depending on the disease found. If neutrophils, monocytes and other types of colorless blood cells often deviate from standard values, this indicates that you need to immediately consult a specialist. It should also be remembered that a decrease in the level of lymphocytes after an illness does not always indicate its complete passage.

Increase in other types of white blood cells

The total level of white blood cells is also a very important indicator. Monocytes and segmented neutrophils can have a direct effect on lymphocyte levels. For example, if these blood cells are relatively low, then lymphocytes are high. and monocytes, this means that a virus or infection is present in the body. Any change in the level of leukocytes in the blood will require repeated analysis, detailed interpretation and a comprehensive examination.

Everyone is well aware that a general blood test must be done strictly on an empty stomach. However, you should be aware that the blood test result may be affected by certain medications, supplements and diets.

Lymphocytosis should be assessed not as an increase in lymphocytes alone, but as a complex phenomenon affecting leukocytes of all types and their leukocyte formula, the absolute content of leukocytes, granulocytes, eosinophils, segmented neutrophils and their percentage.

rice. leukocyte formula

If you have a high level of lymphocytes, ask your doctor what type of lymphocytosis you have:

1. reactive;
2. malignant.

Reactive lymphocytosis– manifests itself in case of an infectious disease or a malfunction of the immune system.

Malignant lymphocytosis– may be a signal of blood leukemia, manifested in chronic form and acute, lymphoproliferative disease.

Reasons why lymphocytes are often elevated

When a bacterium or foreign protein enters the body, a fungal infection in the body turns on the mechanisms of producing an immune response through the bone marrow, which produces an increased number of lymphocytes in the blood in adults and children.

The condition in which increased lymphocytes are detected is called lymphocytosis.

Usually this is always indicated by an excess of lymphocytes in a general blood test (BCC). Sometimes the disease does not manifest itself and is detected only when the patient consults a doctor.

There are many reasons for increased lymphocytes in the blood, which can cause lymphocytosis. Using a variety of symptoms of lymphocytosis, you can try to determine the cause.

When lymphocytes are elevated in an adult, this may indicate the reaction of the immune system to any disease or hidden condition occurring in the body.

This reaction should resolve within 1-2 months after the cessation of the action of the factor causing it, in chronic diseases and acute diseases. May be accompanied by enlarged lymph nodes, enlarged spleen and liver in the patient.

This should not cause the patient to panic about the development of oncology, since only a doctor can determine this.

How to determine what type of lymphocytosis you have

In order to determine what type of lymphocytosis is present, the doctor prescribes additional tests for:

• pathologies of the lymphocytes themselves;
• bone marrow analysis;
• molecular genetic tests.

Each type of leukocyte performs its own function in protecting against viruses and bacteria, foreign cells.

Absolute lymphocytosis

Lymphocytes are higher than normal in absolute lymphocytosis in diseases such as:

• hepatitis,
• Infectious mononucleosis,
• endocrine system diseases
• lymphosarcoma
• Viral infection
• lymphotropic virus

Relative lymphocytosis

This type of lymphocytosis is much more common in humans than absolute lymphocytosis. Emergence relative lymphocytosis, as a rule, is associated with the presence of ailments in the patient, which are characterized by a decrease in the total number of leukocytes in relation to lymphocytes.

The most common type of lymphocytosis, diagnosed by a slightly reduced or normal number of leukocytes.

Infectious lymphocytosis

The introduction of infection into the body activates all the defenses of our body.

Neutrophils are always elevated due to the direct penetration of bacteria, and lymphocytes destroy mainly invading viruses, infectious lymphocytosis.

By joining an infected cell, they place a marker on it and begin to produce special antibodies that eliminate the virus-producing cell.

Relative lymphocytosis diagnosed with each infection, and in some cases, absolute lymphocytosis, which serves as evidence of the body’s struggle and the formation of an immune response.

High lymphocytes can be present throughout the illness, as well as during the recovery period and even for some time after the illness.

Infectious mononucleosis affects the general blood test very clearly.

You can also add some diseases that can develop into a long-term chronic form, for example: syphilis, tuberculosis.

Sometimes reactive lymphocytosis does not always manifest itself, as a consequence of an established infection. The cause of lymphocytosis can be blood cancer, disruption of the hematopoietic system, uncontrolled cell division turning into a malignant tumor.

Infectious lymphocytosis occurs when a lymphotropic virus penetrates, during the formation of an acute viral lesion.

Stress and hormones

During stressful situations, fluctuations in the ratio of neutrophils and lymphocytes in the blood may occur. If you are overly worried, calm down or postpone taking blood tests.

Do not take tests during periods of fatigue or after exhausting physical work.

An increased level of lymphocytes in the blood of women occurs during the monthly cycle. The level remains no higher than 5 * 109 cells per liter and is restored to normal after some time.

Smoking

A non-smoker's general blood test will be very different from a smoker's. Smokers not only have an increased number of lymphocytes, but the blood in general thickens, which is dangerous due to the formation of blood clots and the risk of stroke.

Poisoning and medications

Clinical symptoms of lymphocytosis are not detected, and the disease may not manifest itself.

It is important to get tested and monitor the number of neutrophils, to prevent a significant decrease in immunity (agranulocytosis).

Splenectomy

In some cases, for medical reasons or as a result of injury, surgery to remove the spleen, called a splenectomy, occurs.

As a result of the important role played by the spleen in the breakdown of lymphocytes, temporary lymphocytosis is possible. The body needs time to compensate for the absence of an important organ and the level of lymphocytes will return to normal.

When to sound the alarm

You need to pay attention when, when taking a general blood test, a lot of lymphocytes are constantly detected in your blood.

When an increase in lymphocytes is accompanied by an increase in lymph nodes, liver, spleen, in such cases you need to consult a specialist, oncologist, hematologist.

Additional tests may need to be performed:

• chest x-ray,
• Ultrasound of internal organs,
• cytological and histological examination of bone marrow,
• computed tomography.

Symptoms of lymphocytosis

Symptoms of lymphocytosis:

• Enlarged lymph nodes
• Sleep disturbance
• Nausea
• Loss of appetite
• Fever
• Vomit
• Enlarged spleen
• Diarrhea
• Liver enlargement
• Constipation
• Chills
• Reduced temperature
• Enlarged tonsils
• Exhaustion
• Deterioration of general condition
• Inflammation of the cerebral cortex
• Nasal infections
• Infections of the oral mucosa
• Allergies to foods or substances to which the body did not previously react in any way
• Subtle body temperature is about 37º C and slightly higher for a long period.

Any of these symptoms should alert the patient to undergo medical tests and examination by a doctor to rule out lymphocytosis.

You should definitely take a general blood test along with a leukogram or leukocyte formula to accurately detect an increase in leukocytes in the blood.

Lymphocyte levels are tested for various reasons. One of the reasons is for preventive purposes or when there is a suspicion of the existence of any diseases or poisonings.

This lymphocyte test is also performed to evaluate the effectiveness of certain medications and provide information regarding the correct course of treatment and its effectiveness for a particular patient.

When is a general blood test for lymphocytes prescribed?

A general analysis for lymphocytes and leukocytes is often prescribed in the diagnosis of diseases such as:

• presence of bacteria;
• chronic leukemia;
• lymphocytopenia;
• lymphocytosis;
• mononucleosis;
• SARS - acute respiratory syndrome;
• with a weakened immune system.

It often happens that the lymphocyte test is sometimes performed again. This is done in order to confirm or refute the results obtained earlier.

How to reduce lymphocyte levels

To reduce the number of lymphocytes and lower leukocytes, to normalize hematopoiesis, use the following folk remedies:

Horsetail

Dry herb (15 g) pour a glass of boiling water, cover with a lid and leave overnight. Strain the infusion. Take 20 ml three times a day for a month.

Blackthorn berries

Pour a kilogram of thorn fruit into 400 ml of water and mash with a masher. Leave to sit for 24 hours, then cook for 10 minutes. Cool the product to room temperature and strain. Add honey or sugar, drink 50 ml three times a day before meals. Course - 2–3 weeks.

Lime tea

Brew dry or fresh flowers and young linden leaves. Drink a glass of tea twice a day. Sweeten the drink with sugar or honey.

Tea made from berries and birch buds

Take a teaspoon each of strawberries, lingonberries and birch blossom. Place ingredients in boiling water (250 ml). Cook for 7 minutes, then remove from heat and leave covered for 15 minutes.

Divide the serving into three times and drink after meals. Add sugar or honey if desired.

The listed traditional medicines strengthen the immune system and have a positive effect on the circulatory system. They should not be taken only if you are allergic to the components.

Folk remedies quickly cope with the physiological surge of leukocytes.

If you have serious illnesses, consult a doctor and undergo comprehensive treatment under his supervision.

Question answer

Why are lymphocytes lower in the tests and higher in adults?

Human blood consists of many different formed elements, blood cells. Some of them, leukocytes, protect our body from infection, various bacteria and viruses. The ratio of leukocytes and neutrophils and other blood cells is an indicator of the condition of the body. A case where neutrophils are low and lymphocytes are high may indicate an established infection, a latent inflammatory process, an allergic reaction, or helminthic infestation. Only a doctor can identify the disease and prescribe treatment,

What are the reasons for the increase in lymphocytes and monocytes in the blood?

The reasons for the increase in lymphocytes and monocytes shows the body's immune response.
Monocytes are young cells moving along the bloodstream into body tissues where they turn into mature histiocytes and macrophages. Penetrating into the mucous membranes and skin, macrophages devour (phagocytose) bacteria and foreign protein. An increase in monocytes indicates an established infection.
This condition can occur when:

• acute respiratory infections, fungal diseases, viruses
• In those recovering and some time after illness
• Autoimmune diseases
• Hidden chronic diseases, inflammation
• Blood cancer
• Tumors
• Poisoning with phosphorus, tetrachloroethane

What to do if leukocytes and lymphocytes are elevated?

The reasons may lie in various factors. Get other tests and histological tests besides the blood test. Any infections such as sinusitis or sinusitis and even caries can cause an increase in white blood cells and lymphocytes. The diagnosis can only be made by the attending physician, based on complaints and test results.

With such test results, it is important not to delay your visit to the doctor. This can lead to serious consequences for the body.

What to do when lymphocytes and ESR are elevated?

ESR is the erythrocyte sedimentation rate. An increase in ESR levels may indicate a hidden inflammatory process, or that you have recently been ill and the body has not yet returned to normal.

There are different types of lymphocytes and each performs a specific function in the body.

Types of lymphocytes NK (from English natural killer) normal killers:

• Null lymphocytes
• B lymphocytes
• T lymphocytes

Video: How to lower the level of white blood cells in the blood

A general blood test is one of the most frequently prescribed and objective examinations. If lymphocytes are elevated in the blood, then doctors talk about lymphocytosis. The article describes the reasons for the development of this pathological condition.

What are lymphocytes

Our blood is red because of red cells or red blood cells. But they have faithful neighbors in the bloodstream - lymphocytes. This is a whole group of cells that have one important common quality: all lymphocytes protect the body.

Among them are:

• B cells. They know how to turn into a factory for the production of antibodies to any infections. They are considered the main fighters against bacterial diseases. They are formed in the bone marrow.
• T cells. Formed in the thymus and lymph nodes. T lymphocytes are able to effectively resist viral and fungal infections. It is some of the T cells that activate B lymphocytes, sending them a signal about the presence of infection in the blood.
• Natural killer cells. The most mysterious and few of the lymphocytes, NK cells are capable of fighting cancer in its early stages. Killer cells destroy cells that are different from our body, such as those that have turned into tumor cells or are infected with a virus.

Lymphocytes - norm and pathology

Blood consists of cells that are in a liquid solution. In a classic blood test, the number of lymphocytes is presented as a percentage. This is their relative value. It shows what part of all immune cells is represented by lymphocytes.

Normal relative lymphocyte values ​​depending on age:

We can talk about an increased number of cells if their value is higher than the norm recommended by this laboratory. Lymphocytes actively increase during stress and infections, with tumors and smoking. The increase in lymphocyte levels in these different clinical situations is not always the same.

Doctors distinguish the following types of lymphocytosis:

• Absolute;
• Relative.

With the first case, everything is very clear - there are a lot of lymphocytes in quantitative terms. If percentage numbers are converted into absolute numbers, we get a large number of lymphocytes absolutely. Most often, lymphocytosis is absolute.

A relative increase in the number of lymphocytes is associated with a decrease in the number of other cells, neutrophils. Lymphocytosis is determined as a percentage in a blood test, but the absolute numbers are far from it. This situation occurs when the total number of leukocytes decreases. Therefore, if the analysis determines increased lymphocytes with a low number of white blood cells, it is necessary to recalculate to absolute values.

Causes of lymphocytosis

What does an increased number of lymphocyte cells indicate in adults or children? Among all the possible options for increasing lymphocytes, there are both deadly and harmless conditions. That is why it is important not to panic when changes in a blood test are detected, but to carefully look for the cause. Below we will consider in detail why an increased level of lymphocytes is determined.

Infectious diseases

Lymphocytes are immune cells. They react sharply to any contagious disease. In the acute period, their number can reach large numbers. This is how the body tries to rid itself of germs.

Lymphocytosis occurs with bacterial infections such as:

• Tuberculosis;
• Whooping cough;
• Syphilis.

Classic bacterial infections - sore throat, pneumonia, pyelonephritis - rarely cause lymphocytosis. The causative agents of these infectious diseases cause an increase in the number of neutrophils. But with tuberculosis or whooping cough, the body reacts with lymphocytosis. This is the peculiarity of the microbes that cause these infections.

High numbers of lymphocytes are often diagnosed in viral diseases. This is a feature of the impact of viruses on the human body.

Once in the blood, the pathogens of these infections cause massive proliferation of lymphocytes:

• Herpes;
• Infectious mononucleosis;
• Flu;
• Measles, chickenpox, rubella;
• Adenoviral infection.

It is worth noting that an increase in the number of lymphocytes occurs during the acute period of the disease, reaching a maximum at the height of all symptoms. As you recover, the number of these cells gradually decreases. For several weeks after recovery, lymphocytosis will still be seen on routine blood tests. This is a normal reaction of the human body and does not require treatment.

Autoimmune diseases

Some pathologies are caused not by an external microbe, but by an attack by one’s own body. Immune cells - lymphocytes - begin to actively form antibodies to their cells. The more antibodies created, the stronger the autoimmune inflammation will be.

These are diseases such as:

• Autoimmune thyrotoxicosis;
• Rheumatoid arthritis;
• Crohn's disease;
• Ulcerative colitis.

Antibodies, even such “wrong” ones, are formed precisely by B-class lymphocytes. It is natural that any autoimmune process is accompanied by lymphocytosis. The numbers of lymphocytes in autoimmune diseases increase individually, without correlating with the activity of the process.

Blood tumors

The hematopoietic system can also be affected by the oncological process.

Blood tumors are characterized by excessive formation of a certain type of cell, depending on the type of cancer:

• Myeloblastic leukemia;
• Lymphoblastic leukemia.

Lymphocytosis is observed specifically in lymphoblastic leukemia. Moreover, the values ​​of lymphocytes increase against the background of very pronounced leukocytosis, which does not happen with classical infections. Extremely high, unusual leukocytosis in combination with lymphocytosis should raise red flags for leukemia.

Lymphocytic leukemia can occur in acute and chronic forms. This is determined by a blood test. In acute leukemia, there are many young immature lymphocytes in the bloodstream. They are not able to perform their functions, therefore they are a pathology. Usually there are few or none of them in the blood. In chronic leukemia, the number of mature lymphocytes is increased. But the body does not need them in such large quantities.

Taking medications

Some medications can affect the cell ratio and cause relative or absolute lymphocytosis. You should always tell your doctor about the medications you take. This will help avoid misdiagnosis.

Lymphocytosis can be caused by:

• Anticonvulsants (valproic acid, levodopa);
• Barbiturates;
• Narcotic and non-narcotic analgesics.

If significant lymphocytosis occurs, the drug is discontinued or replaced with a similar one. This is necessary to confirm the drug-induced nature of lymphocytosis. If the indicators increase slightly, then you can return to taking the previous medication.

Stress and hormonal changes

Stressful situations affect absolutely all organs through the central nervous system and endocrine system. People tend to underestimate the damage stress causes to the human body. But it can even manifest itself in changes in blood test parameters and provoke relative lymphocytosis.

In women, cyclical changes in the body can also cause lymphocytosis. During menstruation, the number of lymphocytes in some women increases relatively. If changes are detected in the tests during this period, the blood is re-dated a week later.

Smoking

In this case we will talk about relative lymphocytosis. Constant smoking causes blood to thicken. The ratio of platelets, erythrocytes and leukocytes to the liquid part of the blood increases towards cellular elements. In particular cases, this is manifested by lymphocytosis with preserved values ​​of total leukocytes.

Heavy metal poisoning

Today this is a rare pathology and affects mainly industrial workers. Heavy metals are used in some types of production.

Constant contact with metal vapors leads to the development of chronic intoxications:

• Mercury;
• Bismuth;
• Lead.

In the early stages, lymphocytosis may be the only manifestation of an occupational disease. Over time, the liver, nervous system, and heart are affected. With proper treatment and cessation of contact with metal, the development of intoxication stops.

Splenectomy

Splenectomy is one of the most harmless operations for future life. Its consequences for many people occur without a trace and harmlessly. But in some, removal of the spleen is accompanied by an increase in the number of blood cells, including lymphocytes.

The function of the spleen is to destroy old, useless blood cells. She passes them through herself, filtering and destroying old lymphocytes. When the spleen is removed, the cells spend longer in the bloodstream because there is no one to destroy them. This lymphocytosis does not require treatment and does not affect human health.

Video - Traitor lymphocytes: how to neutralize them

A blood test is the first stage of diagnosis that patients of specialists in any field of medicine encounter. When assessing the results obtained, it is sometimes necessary to interpret situations where lymphocytes in the blood are elevated. Doctors call this condition lymphocytosis. What this may mean, and in what diagnostic direction such a patient should be directed, can only be decided by a specialist. But knowing the possible causes and scenarios will not hurt the patients themselves.

The concept of lymphocyte norms and options for increasing them

Lymphocytes are one of the most important elements of cellular and humoral immunity. A blood test determines their total number without detailed characteristics of the T-cell and B-cell units. The following indicators are considered normal:

• Relative values ​​(percentage of lymphocytes relative to the total level of leukocytes) – from 20% to 40%;
• Absolute values ​​(number of lymphocyte cells per unit volume of blood) – from 1 to 4.5 g/l;
• In children of early age groups, the norm of lymphocytes is slightly higher than in adults. Age-related characteristics must be taken into account in the form of physiological crossover at 5 days and 5 years of age, when the number of leukocytes becomes the same as neutrophil leukocytes.

The results obtained can be assessed using both absolute and relative indicators. In case of pathology and the need for a more thorough diagnosis, a detailed study of the cellular composition of the lymphocytic part of the blood system is carried out. In this case, the following options for increasing lymphocytes in the analysis results can be obtained:

1. Absolute lymphocytosis – clinical and laboratory situations in which the overall level of leukocytes increases due to an increase in the content of lymphocytes;
2. Relative lymphocytosis – lymphocytes are increased, leukocytes are normal. In such cases, lymphocytes increase not due to an increase in their number per unit volume of blood, but due to a decrease in neutrophil leukocytes in the leukocyte formula;
3. A combination of any types of lymphocytosis with an increase or decrease in other blood cells (erythrocytes, platelets).

Important to remember! Leukocytes and lymphocytes are two components of one large immune system. If changes in the leukocyte formula are detected in the form of relative lymphocytosis, it is necessary to determine the number of lymphocytes in absolute numbers!

Diseases of the blood system

Lymphocytes, as an element of blood tissue, are a mirror reflection of the state of hematopoietic processes in the body. In the event of pathology of the bone marrow and lymphatic system, a combined increase in lymphocytes and leukocytes is recorded. Such changes in the analysis are possible if:

• Acute and chronic lymphoblastic leukemia;
• Lymphogranulomatosis;
• Lymphomas and lymphosarcoma;
• Multiple myeloma;
• Metastases of malignant tumors to the bone marrow;
• Radiation injuries.

Viral infections

Lymphocytes are protective cells responsible for antiviral immunity in the body. An increase in their number in the peripheral blood may indicate infection with any viruses, both at the stage of their reproduction and convalescence with the formation of immunity. In the first case, lymphocytosis is caused by a predominant increase in the level of T-cell lymphocytes, and in the second, B-cells. The following can cause such changes in blood tests:

• Respiratory viruses (adenovirus, parainfluenza, influenza);
• Measles, rubella and chickenpox viruses;
• Pathogens of the herpes family, but only when the process is generalized with a wide distribution of the pathogen throughout all tissues of the body;
• Epstein-Barr virus with infectious mononucleosis;
• Hepatitis viruses of all types (A, B, C, etc.).

Lymphocytes are the main cells for the formation of complete and lasting immunity

Bacterial infections

• Whooping cough;
• Syphilis;
• Tuberculosis;
• Brucellosis;
• Toxoplasmosis;
• Mycoplasmosis and ureaplasmosis;
• Chlamydial infection.

Autoimmune diseases

Almost all diseases characterized by the destruction of healthy body tissues by cells of the immune system are accompanied by an increase in the activity of lymphocyte cells. That is why in blood tests it looks like an increase in their percentage or absolute amount compared to the norm. The main autoimmune-allergic diseases accompanied by lymphocytosis are:

• Rheumatoid arthritis;
• Bronchial asthma;
• Chronic skin diseases in the form of dermatoses (psoriasis, eczema);
• Systemic lupus erythematosus.

Other factors

Among the causative mechanisms of increased blood lymphocytes, one can note various internal and external factors, which are very rare, but can act as a cause of lymphocytosis. It can be:

• Hyperthyroidism (increased thyroid function);
• Addison's disease (decreased adrenal function);
• Treatment with hematopoietic stimulants;
• Vaccination against common infections of a child or adult;
• Hepatomegaly and hepersplenism (enlargement of the spleen with increased function). This results in more lymphocyte cells being released into the blood.

Video about the types and functions of leukocytes:

Differential diagnosis of lymphocytosis

In clinical practice, there are various situations in which analyzes record not only pathological changes in the form of lymphocytosis, but also its combination with other changes in the cellular composition of the blood. It can be:

1. An increase in lymphocytes in combination with an increase in the total level of leukocytes (absolute lymphocytosis). Characteristic of lymphoproliferative diseases of the blood system (lymphocytic leukemia, lymphoma, lymphogranulomatosis) and acute severe viral infections;
2. Increased lymphocytes and platelets. Such a combination practically never occurs, since it is not pathogenetically associated with a single cause. Such patients should have two pathologies, each of which causes corresponding increases in indicators. A more typical case may be an increase in lymphocytes against the background of a decrease in platelets, which indicates hypersplenism and autoimmune thrombocytopenic purpura;
3. Red blood cells and lymphocytes are increased. This combination is also paradoxical. It can be determined in the results of a blood test and indicates intoxication against the background of viral and bacterial infections, accompanied by dehydration. If a decrease in red blood cells occurs against the background of lymphocytosis, this speaks in favor of leukemia or other types of lymphoproliferative diseases of the bone marrow;
4. Leukocytes are low, lymphocytes are high. Similar clinical situations are possible with special types of leukopenia, which is called agranulocytosis, after viral infections or against the background of tuberculosis. This phenomenon is explained by the depletion of rapid immunity cells (leukocytes) and the activation of long-term immunity cells (lymphocytes). Long-term course of specific infectious processes and treatment with antibiotics disrupt the synthesis of leukocytes. It will take some time for them to return to normal levels.

Important to remember! An elevated lymphocyte count or lymphocytosis is not a disease. This condition can be regarded solely as a symptom. Only this approach is correct. There is no need to treat lymphocytosis. The disease that led to its occurrence must be treated!

A few years ago I wrote how they differ in general blood test, which cells become more and less numerous during various infections. The article has gained some popularity, but needs some clarification.

Even at school they teach that white blood cell count should be between 4 to 9 billion(× 10 9) per liter of blood. Depending on their functions, leukocytes are divided into several types, therefore leukocyte formula(the ratio of different types of leukocytes) normally in an adult looks like this:

• neutrophils (total 48-78%):
  • young (metamyelocytes) - 0%,
  • stab - 1-6%,
  • segmented - 47-72%,
• eosinophils - 1-5%,
• basophils - 0-1%,
• lymphocytes - 18-40% (according to other standards 19-37%),
• monocytes - 3-11%.

For example, a general blood test revealed 45% lymphocytes. Is it dangerous or not? Should we sound the alarm and look for a list of diseases in which the number of lymphocytes in the blood increases? We’ll talk about this today, because in some cases such deviations in blood tests are pathological, while in others they do not pose a danger.

Stages of normal hematopoiesis

Let's look at the results of a general (clinical) blood test guy 19 years old, sick The analysis was done in early February 2015 in the Invitro laboratory:

Analysis, the indicators of which are discussed in this article

In the analysis, indicators that differ from normal values ​​are highlighted in red. Now in laboratory research the word “ norm" is used less frequently, it is replaced by " reference values" or " reference interval" This is done so as not to confuse people, because depending on what is used, the same value can be both normal and abnormal. Reference values ​​are selected in such a way that the test results correspond to them 97-99% healthy people.

Let's look at the analysis results highlighted in red.

Hematocrit

Hematocrit - proportion of blood volume accounted for by formed blood elements(erythrocytes, platelets and platelets). Since red blood cells are much larger in number (for example, the number of red blood cells in a unit of blood exceeds the number of white blood cells in a thousand times), then in fact the hematocrit shows what part of the blood volume (in%) is occupied red blood cells. In this case, the hematocrit is at the lower limit of normal, and other indicators of red blood cells are normal, so a slightly reduced hematocrit can be considered variant of the norm.

Lymphocytes

In the above blood test 45.6% lymphocytes. This is slightly higher than normal values ​​(18-40% or 19-37%) and is called relative lymphocytosis. It would seem that this is a pathology? But let's count how many lymphocytes are contained in a unit of blood and compare them with the normal absolute values ​​of their number (cells).

The number (absolute value) of lymphocytes in the blood is: (4.69 × 10 9 × 45.6%) / 100 = 2,14 × 10 9 /l. We see this figure at the bottom of the analysis; reference values ​​are indicated nearby: 1,00-4,80 . Our result of 2.14 can be considered good, because it is almost in the middle between the minimum (1.00) and maximum (4.80) level.

So, we have relative lymphocytosis (45.6% greater than 37% and 40%), but no absolute lymphocytosis (2.14 less than 4.8). In this case, relative lymphocytosis can be considered variant of the norm.

Neutrophils

The total number of neutrophils is calculated as the sum of young (normally 0%), band (1-6%) and segmented neutrophils (47-72%), their total 48-78% .

Stages of granulocyte development

In the blood test under consideration, the total number of neutrophils is equal to 42,5% . We see that the relative (%) content of neutrophils is below normal.

Let's do the math absolute neutrophil count per unit of blood:
4.69 × 10 9 × 42.5% / 100 = 1,99 × 10 9 /l.

There is some confusion regarding the proper absolute number of lymphocyte cells.

1) Data from the literature.

2) Reference values ​​for the number of cells from the analysis of the Invitro laboratory(see blood test):

• neutrophils: 1.8-7.7 × 10 9 /l.

3) Since the above figures do not coincide (1.8 and 2.04), let’s try to calculate the limits of normal cell number values ​​ourselves.

• The minimum acceptable number of neutrophils is the minimum number of neutrophils ( 48% ) from the normal minimum of leukocytes (4 × 10 9 / l), that is 1.92 × 10 9 /l.
• The maximum acceptable number of neutrophils is 78% from the normal maximum of leukocytes (9 × 10 9 /l), that is 7.02 × 10 9 /l.

In patient analysis 1.99 × 10 9 neutrophils, which in principle corresponds to normal cell numbers. The level of neutrophils is clearly considered pathological below 1.5× 10 9 /l (called neutropenia). A level between 1.5 × 10 9 /L and 1.9 × 10 9 /L is considered intermediate between normal and pathological.

Should we panic that the absolute number of neutrophils is near the lower limit of the absolute norm? No. At diabetes mellitus(and even with alcoholism) a slightly reduced level of neutrophils is quite possible. To make sure that fears are unfounded, you need to check the level of young forms: normal young neutrophils(metamyelocytes) - 0% and band neutrophils- from 1 to 6%. The commentary to the analysis (does not fit in the figure and is cropped to the right) states:

A blood test using a hematology analyzer did not reveal any pathological cells. The number of band neutrophils does not exceed 6%.

For the same person, the indicators of a general blood test are quite stable: if there are no serious health problems, then the results of tests done at intervals of six months to a year will be very similar. The subject had similar blood test results several months ago.

Thus, the considered blood test, taking into account diabetes mellitus, stability of results, the absence of pathological forms of cells and the absence of an increased level of young forms of neutrophils, can be considered almost normal. But if in doubt, you need to observe the patient further and prescribe repeated general blood test (if an automatic hematology analyzer is not able to identify all types of pathological cells, then the analysis should be additionally examined manually under a microscope, just in case). In the most difficult cases, when the situation worsens, they take bone marrow puncture(usually from the sternum).

Reference data for neutrophils and lymphocytes

Neutrophils

The main function of neutrophils is fight bacteria by phagocytosis(absorption) and subsequent digestion. Dead neutrophils make up a significant part pus with inflammation. Neutrophils are " ordinary soldiers» in the fight against infection:

• a lot of them(every day about 100 g of neutrophils are formed in the body and enter the bloodstream, this amount increases several times during purulent infections);
• don't live long- they circulate in the blood for a short time (12-14 hours), after which they enter the tissues and live for several more days (up to 8 days);
• many neutrophils are released with biological secretions - sputum, mucus;
• the complete development cycle of a neutrophil to a mature cell takes 2 weeks.

Normal content neutrophils in the blood of an adult:

• young (metamyelocytes) neutrophils - 0%,
• stab neutrophils - 1-6%,
• segmented neutrophils - 47-72%,
• Total neutrophils - 48-78%.

Leukocytes containing specific granules in the cytoplasm are classified as granulocytes. Granulocytes are neutrophils, eosinophils, basophils.

Agranulocytosis- a sharp decrease in the number of granulocytes in the blood until they disappear (less than 1 × 10 9 / l leukocytes and less than 0.75 × 10 9 / l granulocytes).

The concept of agranulocytosis is close to the concept neutropenia (decreased number of neutrophils- below 1.5 × 10 9 /l). Comparing the criteria for agranulocytosis and neutropenia, one can guess that only severe neutropenia will lead to agranulocytosis. To give a conclusion " agranulocytosis", a moderately reduced level of neutrophils is not enough.

Causes decreased number of neutrophils ( neutropenia):

1. severe bacterial infections,
2. viral infections (neutrophils do not fight viruses. Cells affected by the virus are destroyed by certain types of lymphocytes),
3. inhibition of hematopoiesis in the bone marrow ( aplastic anemia - sharp inhibition or cessation of growth and maturation of all blood cells in the bone marrow),
4. autoimmune diseases ( systemic lupus erythematosus, rheumatoid arthritis and etc.),
5. redistribution of neutrophils in organs ( splenomegaly- enlarged spleen)
6. tumors of the hematopoietic system:
   • chronic lymphocytic leukemia(a malignant tumor in which the formation of atypical mature lymphocytes occurs and their accumulation in the blood, bone marrow, lymph nodes, liver and spleen. At the same time, the formation of all other blood cells is inhibited, especially those with a short life cycle - neutrophils);
   • acute leukemia(a bone marrow tumor in which a mutation of a hematopoietic stem cell occurs and its uncontrolled reproduction without maturation into mature forms of cells. Both the common stem cell, the progenitor of all blood cells, and later varieties of progenitor cells in individual blood sprouts can be affected. Bone marrow filled with immature blast cells, which displace and suppress normal hematopoiesis);
7. deficiencies of iron and some vitamins ( cyanocobalamin, folic acid),
8. effect of drugs ( cytostatics, immunosuppressants, sulfonamides and etc.)
9. genetic factors.

An increase in the number of neutrophils in the blood (above 78% or more than 5.8 × 10 9 / L) is called neutrophilia (neutrophilia, neutrophilic leukocytosis).

4 mechanisms of neutrophilia(neutrophilia):

1. strengthening education neutrophils:

• bacterial infections,
• inflammation and tissue necrosis ( burns, myocardial infarction),
• chronic myeloid leukemia (a malignant bone marrow tumor in which there is an uncontrolled formation of immature and mature granulocytes - neutrophils, eosinophils and basophils, displacing healthy cells),
• treatment of malignant tumors (for example, with),
• poisoning (exogenous origin - lead, snake venom, endogenous origin - , ),

For purulent bacterial infections characteristic:

• development leukocytosis- increase in the total number of leukocytes (above 9 × 10 9 / l) mainly due to neutrophilia- increase in the number of neutrophils;
• shift of the leukocyte formula to the left- increase in the number of young [ young + stab] forms of neutrophils. The appearance of young neutrophils (metamyelocytes) in the blood is a sign of a severe infection and evidence that the bone marrow is working under great strain. The more young forms (especially young ones), the greater the stress on the immune system;
• appearance toxic granularity and others degenerative changes in neutrophils (Dele bodies, cytoplasmic vacuoles, pathological changes in the nucleus). Contrary to the established name, these changes are not caused by “ toxic effect» bacteria to neutrophils, and cell maturation disorder in the bone marrow. The maturation of neutrophils is disrupted due to a sharp acceleration due to excessive stimulation of the immune system, therefore, for example, toxic granularity of neutrophils appears in large quantities during the disintegration of tumor tissue under the influence of radiation therapy. In other words, the bone marrow prepares young “soldiers” to the limit of their capabilities and sends them “into battle” ahead of schedule.

Drawing from the site bono-esse.ru

Lymphocytes

Lymphocytes are the second most numerous leukocytes in the blood and come in different subtypes.

Brief classification of lymphocytes

Unlike neutrophils, the “soldiers,” lymphocytes can be classified as “officers.” Lymphocytes “train” longer (depending on the functions they perform, they are formed and multiply in the bone marrow, lymph nodes, spleen) and are highly specialized cells ( antigen recognition, initiation and implementation of cellular and humoral immunity, regulation of the formation and activity of cells of the immune system). Lymphocytes are able to leave the blood into the tissues, then into the lymph and with its current return back to the blood.

To decipher a general blood test, you need to have an idea of ​​the following:

• 30% of all peripheral blood lymphocytes are short-lived forms (4 days). These are the majority of B lymphocytes and T suppressor cells.
• 70% lymphocytes - long-lived(170 days = almost 6 months). These are other types of lymphocytes.

Of course, with complete cessation of hematopoiesis First, the level of granulocytes in the blood drops, which becomes noticeable precisely by the quantity neutrophils, because the eosinophils and basophils in the blood and normally very little. A little later the level begins to decrease red blood cells(live up to 4 months) and lymphocytes(up to 6 months). For this reason, bone marrow damage is detected by severe infectious complications, which are very difficult to treat.

Since the development of neutrophils is disrupted earlier than other cells ( neutropenia- less than 1.5 × 10 9 /l), then in blood tests it is most often detected relative lymphocytosis(more than 37%), and not absolute lymphocytosis (more than 3.0 × 10 9 / l).

Causes increased level of lymphocytes ( lymphocytosis) - more than 3.0 × 10 9 /l:

• viral infections,
• some bacterial infections ( tuberculosis, syphilis, whooping cough, leptospirosis, brucellosis, yersiniosis),
• autoimmune connective tissue diseases ( rheumatism, systemic lupus erythematosus, rheumatoid arthritis),
• malignant tumors,
• side effects of drugs,
• poisoning,
• some other reasons.

Causes decreased level of lymphocytes ( lymphocytopenia) - less than 1.2 × 10 9 / l (according to less stringent standards 1.0 × 10 9 / l):

• aplastic anemia,
• HIV infection (primarily affects a type of T lymphocyte called T-helpers),
• malignant tumors in the terminal (last) phase,
• some forms of tuberculosis,
• acute infections,
• acute radiation sickness,
• (CRF) in the last stage,
• excess glucocorticoids.