Lymphocytosis concept of the cause and types of symptomatology diagnosis therapy

If relative lymphocytosis in most cases does not require any treatment and is actually a reflection of the normal functioning of the immune system during infection, then an absolute increase in the number of lymphocytes is almost always considered an indication of serious changes and therefore this indicator cannot be ignored. Not being an independent disease, lymphocytosis accompanies a variety of pathological changes and special conditions of the body’s immune system.

The causes of lymphocytosis are extremely diverse, but there is always a “provocative” agent – a virus, a bacterium, a cancer cell. Absolute lymphocytosis can accompany: • Acute viral respiratory infections; • Whooping cough; • Introduction of cytomegalovirus, hepatitis virus; • Infectious mononucleosis; • tuberculosis; • Toxoplasma lesion;

• Dysfunction of the thyroid gland and adrenal glands; • Malignant tumors, where the main substrate is white blood cells (lymphocytic leukemia, paraproteinemia). Relative lymphocytosis reflects viral infections, is characteristic of the healing process after them, is found in patients with rheumatic diseases, enlarged spleen.

Relative lymphocytosis is considered a normal variant in children of the first two years of life. In pediatrics, a relative increase in lymphocytes is quite common. Children are more susceptible to all kinds of infections, in the first years of life only the formation of immunity and a meeting with a variety of pathogens. Lymphocytosis appears with respiratory infections, rubella, measles, scarlet fever, chickenpox.

Some experts believe that even strong physical exertion and frequent stresses in a child can provoke some changes in the blood formula. In adults, infections are also among the main causes of lymphocytosis, but with an absolute increase in the number of lymphocytes, the probability of a malignant tumor of the hematopoietic system is high.

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Keeping of

Relative lymphocytosis appears when the number of other white blood cells in the blood changes, as a result of which the percentage of these cells rises at an acceptable value. This condition is most often found in adults and indicates pathological processes in the body. Therefore, you should know the causes of relative lymphocytosis in adults, and how to treat this ailment.

Types of lymphocytosis

One of the cells of the human immune system are lymphocytes. They are formed in the bone marrow and protect the body from such foreign microorganisms as bacteria and infections, and also participate in the process of their destruction. Due to the number of lymphocytes, you can find out about the state of health and the presence of a disease.

Lymphocytosis in adults is characterized by an increased number of lymphocytes compared to the normal value.

Deviation of indicators from the norm can provoke the following reasons:

  • viral infections (chickenpox, whooping cough, acute respiratory viral infections, hepatitis);
  • bacteria (syphilis, tuberculosis);
  • blood transfusion after surgery;
  • burns and injuries;
  • breakdown;
  • smoking;
  • oncological tumors;
  • lack of vitamin B12 in the body.

In addition, the indicator can be affected by poor nutrition or starvation, the use of alcoholic beverages, and the use of certain medications. In women, this phenomenon can provoke heavy menstruation or the postpartum period, when severe blood loss is observed. As a rule, relative lymphocytosis disappears on its own after eliminating all pathological causes.

In children, usually lymphocytosis does not indicate the development of serious ailments, since their immune system is unstable. Despite this, the doctor should additionally examine the child and exclude dangerous pathological processes.

The lymphocytosis rate is divided into two types:

Relative lymphocytosis occurs in patients with pathologies that are characterized by a decrease in the total number of white blood cells in relation to lymphocytes. Usually, viral and infectious diseases develop at this stage.

The relative size of lymphocytes is indicated in the white blood cell count. It calculates the percentage of other indicators. With the confirmation of this symptom, the level of lymphocytes reaches more than 40%.

Relative lymphocytosis is a common occurrence, as many factors can affect the decrease in the level of other white blood cells. This symptom is more common in adults and children under two years of age.

The causes of such a blood test can characterize various diseases:

  • viral infections;
  • inflammation with pus;
  • rheumatism;
  • typhoid fever;
  • brucellosis;
  • Addison’s disease;
  • pathology of the thyroid gland.

Typically, lymphocytosis does not manifest itself in any way, and it is diagnosed with a blood test, but sometimes symptoms of the underlying disease may appear. These symptoms are often reported to the doctor.

An infectious lesion is characterized by temperature, tonsils and lymph nodes increase, weakness and nausea are observed. A rash and redness of the skin may appear on the patient’s skin. Often there is a fever, chills and a rapid decrease in body weight. Sometimes the liver or spleen enlarges.

Therefore, it is important, in addition to the main symptoms, to check all the indicators and conduct an additional examination, make the correct diagnosis. In this case, the treatment will be effective and the parameters of the lymphocytes will return to normal.

Therapies

Special therapy for relative and absolute lymphocytosis does not exist, since such a phenomenon implies a symptom of a disease. It is necessary to identify the causes, and then prescribe the appropriate treatment for the underlying disease.

For blood cancer, radiation and chemotherapy, cytostatics, and in some cases bone marrow transplantation are required. For bacterial infections, antibiotics are used. If viruses were the reason for the increase in lymphocytes, then antiviral drugs and interferons are prescribed. If the disease is accompanied by increased body temperature, then they drink antipyretic drugs.

An important task in relative lymphocytosis is the removal of the main inflammatory process. Therefore, the symptoms are eliminated by hormonal, anti-inflammatory and mixed drugs.

Thus, the specific treatment of relative lymphocytosis is aimed at eliminating the root cause, which influenced a significant increase in the parameters of protective cells.

Lymphocytes are responsible for protecting the body’s immune system, they circulate through the blood and tissues, identifying and destroying pathogens and extraneous microorganisms. Thus, the level of lymphocytes may indicate the state of the body at the moment. Lymphocytosis is a condition in which there are too many lymphocytes in the blood compared to the norm.

Relative lymphocytosis, that is, an increase in the number of lymphocytes in the blood, is much more common than absolute. In most cases, it indicates any health problems. Each group of diseases is characterized by specific changes in laboratory tests, since these cells play a major role in the body’s immune defense.

Relative and absolute lymphocytosis

Moreover, not only the figure indicating the content of such blood cells is important, but also their percentage ratio in comparison with other types of white blood cells.

Lymphocytes are one of the groups of white blood cells, white blood cells.

Their number varies depending on age, the norm for adults is the number 4,0 – 9,0 × 109 cells per liter, in children this value ranges from 6,5 – 12,5 × 109 cells per liter.

Of this amount, from 19 to 37% (at an early age up to 50%) are lymphocytes, the rest are neutrophils, basophils, eosinophils and monocytes. These indicators are on the form of a detailed clinical analysis with leukoformula counting.

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Relative lymphocytosis is an increase in the percentage of lymphocytes without changing their total amount in the blood. Usually this is combined with a decrease in the level of other formed elements – neutrophils.

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In simple words, lymphocytes are a kind of “rescue squad” that is the first to respond to the ingress of pathogenic microflora into the body.

Therefore, the causes of relative lymphocytosis are almost any viral infection, concomitant neutropenia indicates an acute development of the disease. At the same time, a decrease in the level of leukocytes (leukopenia) is also noted.

Absolute lymphocytosis appears on the background of acute diseases, malignant processes of the hematopoietic system, immunodeficiency. It is worth paying attention to such symptoms in children.

Pediatricians emphasize that far from always the cause of deviations from the norm are any infections.

BOTTOM Line - Lymphocytosis concept of the cause and types of symptomatology diagnosis therapy

First of all, it is worth saying that sometimes the symptoms of absolute and relative lymphocytosis have completely physiological causes.

For example, in women, this symptom is noted in the first days of menstruation, in children the number of such cells increases after prolonged exposure to the sun.

In addition, up to 2 – 3 years of age, lymphocytosis is caused by physiological causes, accompanied by processes of age-related development of the hematopoiesis system. Diseases in which the level of lymphocytes rises and neutropenia is noted include:

  • SARS, including influenza and diseases caused by adeno- and rhinovirus;
  • acute viral infections, such as measles, rubella, mononucleosis, CMV, whooping cough, and mumps;
  • parasitic infestations (usually this is combined with an increase in the number of eosinophils);
  • some bacterial diseases (this is tuberculosis, syphilis);
  • malignant lesions of the bone marrow, accompanied by a decrease in the number of leukocytes (leukopenia) and neutrophils (neutropenia);
  • thyroid dysfunction (hypothyroidism);
  • Crohn’s disease (a chronic process of the gastrointestinal tract);
  • anemia;
  • lymphotropic viruses (there are four groups of them), which provoke diseases such as T-cell leukemia and T-cell lymphoma.

Sometimes relative (less often, absolute) lymphocytosis indicates an allergic reaction.

Other names and synonyms

Titles

32472 - Lymphocytosis concept of the cause and types of symptomatology diagnosis therapyLymphocytosis

Description

Lymphocytosis is a pathological condition that is characterized by an increased number of lymphocytes in the peripheral blood.
Lymphocytosis is not considered an independent disease. This phenomenon accompanies a wide variety of pathologies and serves as a marker of ill-being or the healing process.

Normal values

In different sources, you can find different indicators of the norm of lymphocytes, on average, their number should be 20-40%. In absolute numbers, lymphocytes make up 0,8-3,6 grams of cells per liter of peripheral blood.

32472 1 - Lymphocytosis concept of the cause and types of symptomatology diagnosis therapyLymphocytosis

Additional facts

White blood cells (leukocytes) form the main link of immunity, they can neutralize foreign particles themselves, synthesize specific protective proteins (immunoglobulins) and keep a memory of a meeting with a pathogen for decades and even a lifetime.
Lymphocytes account for up to 40% of all white blood cells; they distinguish between T-lymphocytes, which are involved mainly in cellular reactions to the “alien” and B-lymphocytes that produce immunoglobulins. In different phases of the disease, the number of certain fractions of lymphocytes may differ, and their total number increases.
In the process of recovery, the lymphocytes gradually return to normal, but for quite some time after the infection, the indicator may remain elevated. If lymphocytosis is constantly present for no apparent reason, this is an alarming symptom that can indicate malignant tumors and severe immune disorders.

>Absolute and relative lymphocytosis are distinguished depending on the total number of lymphocytes in the blood.
Relative lymphocytosis is indicated when their number in a liter of blood remains unchanged, and only the percentage ratio with other fractions of white blood cells changes. Such lymphocytosis occurs much more often and is usually accompanied by an increase or decrease in the total number of leukocytes due to other components of the white sprout hematopoiesis formula.
Absolute lymphocytosis means that the mass of lymphocytes in the blood volume is increased, that is, their absolute number, regardless of the concentration of other cells of the white sprout, although against the background of an increase in the number of lymphocytes there will also be an increase in the total number of white cells.
Relative lymphocytosis, as a rule, is an indicator of recovery or a recent infection, often occurs in both adults and children in the initial phase of viral diseases, therefore, when it is detected in the analysis, you do not have to panic, but it is worth remembering what the patient was ill in the near future and if there are any new symptoms of an incipient infection.

Causes

If relative lymphocytosis in most cases does not require any treatment and is actually a reflection of the normal functioning of the immune system during infection, then an absolute increase in the number of lymphocytes is almost always considered an indication of serious changes and therefore this indicator cannot be ignored.
Not being an independent disease, lymphocytosis accompanies a variety of pathological changes and special conditions of the body’s immune system. The causes of lymphocytosis are extremely diverse, but there is always a “provocative” agent – a virus, a bacterium, a cancer cell.
Absolute lymphocytosis may accompany:
• Acute viral respiratory infections;
• Whooping cough;
• Introduction of cytomegalovirus, hepatitis virus;
• Infectious mononucleosis;
• tuberculosis;
• Toxoplasma lesion;
• Dysfunction of the thyroid gland and adrenal glands;
• Malignant tumors, where the main substrate is white blood cells (lymphocytic leukemia, paraproteinemia).
Relative lymphocytosis reflects viral infections, is characteristic of the healing process after them, is found in patients with rheumatic diseases, enlarged spleen. Relative lymphocytosis is considered a normal variant in children of the first two years of life.
In pediatrics, a relative increase in lymphocytes is quite common. Children are more susceptible to all kinds of infections, in the first years of life only the formation of immunity and a meeting with a variety of pathogens. Lymphocytosis appears with respiratory infections, rubella, measles, scarlet fever, chickenpox. Some experts believe that even strong physical exertion and frequent stresses in a child can provoke some changes in the blood formula.
In adults, infections are also among the main causes of lymphocytosis, but with an absolute increase in the number of lymphocytes, the probability of a malignant tumor of the hematopoietic system is high.

Since lymphocytosis is not an independent pathology, but a reflection of other diseases, its manifestations will not differ in specificity. Symptoms depend on the type of lymphocytosis and the cause that caused it.
If lymphocytes are elevated due to a viral infection, then no signs of this laboratory syndrome can be expected. In the clinic, fever, cough, sore throat, runny nose, intestinal disorders will come to the forefront. Examination will reveal not only lymphocytosis, but also other deviations in the analyzes.
In the event that the blood formula changes already in an adult or child who has had some kind of infection, the state of health will be at all close to normal, the symptoms of the disease will be absent.
Often parents of babies worry about such relative lymphocytosis, trying in vain to discover its cause and subjecting the child to endless examinations. If the total number of white blood cells is close to normal, and the fact of a viral infection is confirmed, even if it was a month or two ago, you don’t need to worry too much, you just need to monitor the condition of the child and after some time redo the analysis.
Absolute lymphocytosis can be a big problem. If the number of lymphocytes increases due to a tumor of the hematopoietic tissue, then the symptoms will indicate an increase in neoplasia. There will be bone pain, the spleen and liver will increase, the fever will become constant, signs of bleeding disorders are likely – bleeding, infections become frequent and more severe due to a general decrease in immunity.
Often changes in the number of lymphocytes are combined with other abnormalities in the blood test.
So, lymphocytosis and neutropenia are very characteristic of viral infections – SARS, whooping cough, diphtheria, sepsis and also during the recovery period, this anomaly can be detected.
Some immunodeficiency syndromes can also give this picture of blood. A decrease in the number of segmented leukocytes leads to an increase in the percentage of lymphocytes, therefore, with neutropenia, lymphocytosis is often relative and the symptoms will be caused not so much by lymphocytosis as by a lack of neutrophils – fever, frequent infections of the respiratory and genitourinary tract, and fungal infections.
With severe neutropenia and relative lymphocytosis, the risk of secondary infectious complications is high. This phenomenon can not be considered either the norm or the reaction to the disease, if the absolute number of segmented white blood cells decreases to one and a half or less in a liter of blood.
The combination of “lymphocytosis and monocytosis”, when the number of monocytes also increases, is characteristic of some childhood infections – measles, chickenpox, mumps, in such cases it does not pose a significant threat. With a significant increase in the cells of these two groups, the doctor may suspect monocytic leukemia, myelodysplastic syndrome, which are referred to as malignant tumors of the hematopoietic system.
Infectious mononucleosis is a viral infection accompanied by significant lymphocytosis with the appearance of atypical mononuclear cells in the blood, the precursors of which are monocytes. Symptoms of the disease are reduced to catarrh of the upper respiratory tract, tonsillitis, fever, an increase in all groups of cervical, submandibular lymph nodes, spleen, and jaundice is possible.
Strong intoxication and bacterial infections can cause an increase in the total number of leukocytes to large numbers along with relative or absolute lymphocytosis, and a high leukocytosis will be revealed in the analysis. This phenomenon is often found in young children. Symptoms of a viral infection with fever for 3-5 days are present, catarrhal phenomena, a rash is possible. The number of leukocytes can reach 50×109 per liter of blood, and the lymphocytes in it will be up to 80%.
Long-existing, a kind of chronic lymphocytosis, may be a sign of a sluggish infection, immunodeficiency syndrome, or an oncological process beginning. Typically, such patients experience constant weakness, complain of prolonged fever, frequent colds.

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Treatment

As such, lymphocytosis per se does not require treatment. Its expediency and appearance are determined by the root cause. If the patient recovers after the infection and does not show complaints, then only the laboratory indicator should not be treated. In a few months, he will definitely return to normal, or maybe earlier.
When lymphocytes indicate an acute infection, the doctor will prescribe antiviral drugs or antibiotics, antifungal agents, heavy drinking, and antipyretic drugs.
If the treatment is approximately the same for the majority of patients with acute respiratory viral infections, then in case of confirmation of a malignant tumor, it will be necessary to prescribe cytostatics, immunosuppressants, detoxification therapy, and antibacterial agents and fungicides will be used to prevent infections.
The question of the prevention of lymphocytosis is, rather, a warning of the appearance of its causes. So, in order to avoid fluctuations in the number of lymphocytes, immunity should be strengthened by a healthy lifestyle and tempering, in the cold season, when the probability of infection with respiratory viruses is very high, you need to avoid crowded places, take vitamins and minerals.
If the infection catches up and lymphocytosis is diagnosed in the blood, you should not panic, because after recovery the blood counts will return to normal. The same applies to babies, especially prone to frequent colds.
In the event that unmotivated weakness, prolonged fever, and other unexplained symptoms appear, it is worth taking a general blood test, and if there is a significant increase in lymphocytes, the doctor will never leave him unattended, prescribing a thorough examination and the necessary treatment.

Evidence

Lymphocytosis is not an independent pathology, but is one of the laboratory symptoms of very different diseases (in most cases, infectious). Therefore, signs of lymphocytosis are represented by symptoms of a disease that has caused changes in the cellular composition of peripheral blood.

Such symptoms include:

  • lymphadenopathy (swollen lymph nodes);
  • hepatomegaly (enlarged liver);
  • splenomegaly (enlarged spleen);
  • hyperemia of the mucous membrane of the pharynx;
  • sore throat;
  • cough;
  • rhinitis;
  • general weakness, increased fatigue;
  • decreased appetite;
  • fever (possibly with chills);
  • sleep disturbances;
  • increased sweating.

Diagnostics

1529065403 473108 - Lymphocytosis concept of the cause and types of symptomatology diagnosis therapy

Clinical diagnosis of lymphocytosis is based on a blood test

5489277385757340a59f731.01506292 - Lymphocytosis concept of the cause and types of symptomatology diagnosis therapy

First, an anamnesis is taken, a physical examination is performed, and then the doctor prescribes laboratory tests. The concentration of lymphocytes is recommended to be measured in the morning. The number of leukocytes is influenced by the psychotropic or medicinal substances used by the patient. For this reason, patients should inform the doctor about taking any medication.

Before taking a blood test, you must refrain from cigarettes to prevent distortion of the result. The choice of further diagnostic methods directly depends on the underlying disease that caused lymphocytosis.

Regular visits to the doctor in combination with a blood test can reveal an increased number of lymphocytes at an early stage. After further research, the doctor can determine which of the diseases described above leads to a change in the number of lymphocytes in the blood. Many types of infections can be relieved by vaccination (flu shot, measles in infants from 11 months old). Preventive vaccines can be given when planning trips to countries where you can expect yellow fever and other diseases.

With lymphoma, it is required in the early stages to consult a doctor. The sooner therapy begins, the higher the chances of recovery or slow the progression of the disease. Many precautions are paid for by health insurance companies.

Every 2 years after 35 years, it is recommended to take not only blood tests, but also urine tests, electrocardiography and radiography.

Diagnosis of lymphocytosis is carried out according to the results of a general (clinical) blood test.

With absolute lymphocytosis in patients, an increased number of lymphocytes is combined with an increase in the total number of leukocytes.

The combination of relative lymphocytosis and thrombocytopenia (a decrease in platelet count) is most often observed with autoimmune thrombocytopenic purpura or hypersplenism.

In bacterial and viral infections accompanied by dehydration of the patient (high fever, frequent vomiting, diarrhea), a simultaneous increase in lymphocytes and red blood cells is detected in the analysis of peripheral blood.

Tuberculosis and many viral infections are accompanied by the development of leukopenia (a decrease in the total number of leukocytes) in combination with relative lymphocytosis.

Lymphocytosis treatment

As such, lymphocytosis per se does not require treatment. Its expediency and appearance are determined by the root cause. If the patient recovers after the infection and does not show complaints, then only the laboratory indicator should not be treated. In a few months, he will definitely return to normal, or maybe earlier. When lymphocytes indicate an acute infection, the doctor will prescribe antiviral drugs or antibiotics, antifungal agents, heavy drinking, and antipyretic drugs.

If the treatment is approximately the same for the majority of patients with acute respiratory viral infections, then in case of confirmation of a malignant tumor, it will be necessary to prescribe cytostatics, immunosuppressants, detoxification therapy, and antibacterial agents and fungicides will be used to prevent infections.

The question of the prevention of lymphocytosis is, rather, a warning of the appearance of its causes. So, in order to avoid fluctuations in the number of lymphocytes, immunity should be strengthened by a healthy lifestyle and tempering, in the cold season, when the probability of infection with respiratory viruses is very high, you need to avoid crowded places, take vitamins and minerals.

If the infection catches up and lymphocytosis is diagnosed in the blood, you should not panic, because after recovery the blood counts will return to normal. The same applies to babies, especially prone to frequent colds. In the event that unmotivated weakness, prolonged fever, and other unexplained symptoms appear, it is worth taking a general blood test, and if there is a significant increase in lymphocytes, the doctor will never leave him unattended, prescribing a thorough examination and the necessary treatment.

Since lymphocytosis, as mentioned above, is not an independent disease, but just one of the laboratory criteria inherent in many pathologies, its treatment, or rather, the treatment of the disease that caused it, differs in each case.

Physiological lymphocytosis in children does not require therapy. In other cases, treatment of lymphocytosis should be prescribed only by a doctor, after conducting the necessary examination of the patient and establishing an accurate diagnosis.

In infectious diseases, patients are prescribed antibiotics, sulfonamides, antiviral or anti-inflammatory drugs according to indications.

Tuberculosis patients are prescribed specific tuberculosis therapy (DOTS therapy).

a3603f993824192cbe12eba16bf68536 - Lymphocytosis concept of the cause and types of symptomatology diagnosis therapy

Lymphocytosis in patients with malignant diseases (lymphogranulomatosis, lymphocytic leukemia) requires long-term therapy with cytostatic drugs in the form of mono- or polychemotherapy, and in some cases bone marrow transplantation.

There is no treatment for lymphocytosis, since this condition is not an independent disease. Therapy is determined by the cause, which provoked an increase in the level of lymphocytes in the blood.

In acute infections, antiviral drugs or antibiotics are prescribed. Antifungal agents may be required. For a speedy recovery, you need to drink as much fluid as possible, symptomatic treatment is carried out in parallel, aimed at lowering body temperature, eliminating pain, relieving intoxication, etc.

If a malignant tumor is detected, the patient is prescribed cytostatics, immunosuppressants. In order to prevent complications from joining the patient, fungicides and antibiotics are prescribed.

To prevent the development of lymphocytosis, it is necessary to direct efforts to strengthen immunity, lead a healthy lifestyle, eat right, and temper. During periods of outbreaks of viral infections, crowded places should be avoided, hands should be washed with soap, and vitamin and mineral complexes should be taken.

Lymphocytosis is not a cause for panic. Most likely, after getting rid of the disease, the lymphocytes will come back to normal on their own. In any case, with the appearance of unexplained weakness, with prolonged subfebrile condition and other pathological symptoms, you need to consult a doctor and undergo a comprehensive examination. The faster the treatment is prescribed, the higher the chances of a speedy recovery.

Article author: Mochalov Pavel Aleksandrovich | D.M.N. general practitioner

Education: Moscow Medical Institute I. M. Sechenov, specialty – “Medical business” in 1991, in 1993 “Occupational diseases”, in 1996 “Therapy”.

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Svetlana Borszavich

General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
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