The causes and treatment of monocytosis in adults and children

Monocytosis is divided into absolute and relative.

The difference between them is the degree of increase in monocytes. If the norm is exceeded by no more than 8%, it is relative and is a variant of the norm. Everything above this is an absolute view, and this is a pathology.

Absolute monocytosis occurs when:

  • sepsis;
  • massive inflammation;
  • autoimmune diseases;
  • infectious diseases;
  • and some diseases associated with changes in the hematopoietic function of the bone marrow (for example, leukemia).

In general, monocytosis in the blood means that the human body is desperately fighting the disease, immunity is strained to the limit. It may also be a sign of an attack by the immune system on its own tissues and organs. And finally, an oncological disease can change the order of formation of the leukocyte formula.

In more detail, the cause is determined using other indicators of a general blood test, the percentage of the elements of the leukocyte formula, and based on them, narrower studies are prescribed.

Symptoms of monocytosis most often include the usual symptoms of inflammation, namely:

  1. Weakness.
  2. Headache.
  3. Constant fatigue.
  4. Dizziness.
  5. Low-grade fever.

One of the most active leukocyte fractions involved in the body’s immune defense is rather large blood cells – monocytes. They develop in monocytic germs of bone marrow hematopoiesis and perform a phagocytic function, therefore they are also known as macrophages and phagocytic mononuclear cells.

Simply put, the role of monocytes in the blood and tissues is to absorb foreign bodies (viruses, fungi, bacteria, and even tumor cells), which enter the body for various reasons.

Thanks to monocytes, the blood is also cleansed of the remnants of destroyed or dead, spent cells. However, to activate the phagocytic activity of a normal, standard number of monocytes is not enough. Therefore, all kinds of infections or inflammatory processes in the body are accompanied by a quantitative surge in the monocytic fraction in the blood – this condition is called monocytosis.

Despite the atypicality, the rarity of the phenomenon (monocytes do not often increase in the blood without participation in the process of other leukocyte fractions), monocytosis has 2 varieties or categories – absolute and relative monocytosis.

In the results of the analysis received on hand, the patient most often sees the relative value of the number of monocytes, which is determined by the percentage of the number of monocytes to the total number of leukocyte bodies of other fractions (basophils, neutrophils, eosinophils).

Normally, this value is 3-7%, which means that if an excess of the level of monocytes is determined by 8% or more, we are talking about a condition called relative monocytosis.

At the same time, which is the most characteristic sign, the total number of leukocytes in the blood remains at the normal level. That is, against the background of increased monocytes, the indices of other fractions, for example, lymphocytes or granulocytes, can be lowered, which means that the equilibrium in the leukocyte formula is maintained. This indicator has practically no diagnostic value.

Absolute monocytosis is characterized by an increase in the absolute number of monocytic cells (over 0,7 × 10 9 units per liter) while increasing the level of other leukocytes.

This deviation is pathological and requires additional diagnostic procedures to establish its exact causes. The most common causes of absolute monocytosis are infectious and oncological diseases, therefore, therapeutic measures should be taken as soon as possible when it is detected.

If the maximum achievable number of monocytes is increased, it is an absolute deviation. The level of monocytes exceeded by more than 7 billion cells per liter, indicates absolute monocytosis in children. In general, this indicator also depends on age.

If the percentage of monocytes is exceeded, relative to other forms of leukocyte cells, this is relative monocytosis. Relative monocytosis in an adult is observed with an increase in the percentage of monocytes in the total leukocyte composition over 8%. In children under 12 years of age, monocytosis is considered the limit – monocytes 12%. For adults, the limit is even lower – 11%.

Absolute monocytosis in adults is of great diagnostic importance for the doctor and patient compared with relative, which can vary slightly with stress, trauma, etc.

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Most often, people will learn that they have monocytosis, based not on their own sensations, but on the indicators of the result of a blood test. However, the following symptoms of monocytosis can be distinguished:

  • Weakness;
  • Fast fatiguability;
  • Chronic fatigue;
  • Low-grade temperature: when the body temperature is kept at 37-37,5 ° C for a long period.

However, these symptoms are observed in many different diseases, and you cannot focus only on them when making a diagnosis.

The increase in monocytes in the analysis is of concern to patients. Experienced doctors know that by the content of only one type of blood cells, no conclusion can be made about the state of health. When asked why some cells are increased and others are reduced, there are no definite answers.

Any changes in the blood test are used as an addition to the symptoms of the disease, are taken into account in the differential diagnosis and treatment appointment.

To understand when and in what ways an increased level of monocytes causes pathology in the body, one needs to recall the role of these cells in supporting health.

An increase in the number of immune cells is usually not limited to an increase in the monocyte count. Often the analysis also shows a pathological increase in other phagocytic particles. Despite this fact, monocytosis is absolute or relative. The normal value for men and women is in the range from 3 to 11% or 0,09 – 0,6 * 109 per liter.

Absolute monocytosis in adults is characterized by the accumulation of the number of specific cells in combination with a general increase in leukocytes. Unlike relative monocytosis, with an absolute number of cells should exceed 0,7 * 109 per liter. It is this indicator that often indicates the presence of a severe infection or cancer. Absolute monocytosis requires immediate diagnosis and additional studies.

The norm of monocytes for an adult

What is monocytosis? Its causes and symptoms

Monocytosis is an increase in the total number of monocytes (leukocytes-agranulocytes lacking granules and grains) in the peripheral blood or an increase in their percentage in the cell population of a white blood-forming sprout.

Monocytosis is not considered an independent disease, it does not require a separate treatment, but it is an important laboratory indicator that indicates the presence of pathology in the body (often of an infectious nature).

An increase in the absolute number of monocytes (above 1,0 x 10 9 / L) is observed in a number of pathological conditions. Most often, the causes of monocytosis are:

  • Diseases caused by invasion of a bacterial infection in the body (syphilis, bacterial endocarditis, tuberculosis, rickettsiosis, brucellosis, diphtheria), as well as protozoa (protozoal infection – leishmaniasis, malaria) or fungi;
  • Diseases of viral origin (infectious mononucleosis – Epstein-Barr virus, which belongs to the herpesvirus family), hepatitis, childhood infections caused by viruses (measles, rubella);
  • Tumors of the hematopoietic tissue (leukemia, paraproteinemic hemoblastosis, lymphogranulomatosis, monocytic and myelomonocytic leukemia, preleukemia);
  • Pathological processes occurring with productive inflammation and the formation of granulomas (tuberculosis, sarcoidosis, ulcerative colitis), since macrophages play a decisive role in the formation of huge granuloma cells capable of phagocytosis;
  • Systemic diseases of the connective tissue called collagenoses (rheumatic fever – rheumatism, RA – rheumatoid arthritis, SLE – systemic lupus erythematosus);
  • Intoxication with inorganic and organic chemicals (phosphorus – P and its compounds, carbon tetrachloride – C2H2Cl4 etc.) when they enter (usually through the respiratory system) into the body;
  • Malignant neoplasms;
  • After surgery;
  • The recovery period after infectious diseases (respiratory viral infections, measles, rubella, diphtheria and others), when the weakening of the symptoms of the disease is parallel to a decrease in monocytes in the peripheral blood. Meanwhile, the opposite picture (the recovery, as it were, occurs, but monocytosis remains at the same level) may indicate that the infectious agent has not been completely eradicated and the disease takes on a chronic form.

Typically, monocytosis is accompanied by an increase in the blood of granular forms of leukocytes – neutrophils, because monocytes arrive in the outbreak immediately after this population of granulocytes, which are the first to feel an inflammatory reaction. However, sometimes there are situations when monocytosis and neutropenia are simultaneously present in the blood test.

This is due to certain violations in the immune system, when the lack of some factors is somewhat offset by the active work of others. For example, in certain immunodeficiency states, a certain decrease in the level of neutrophils does not particularly reduce the activity of macrophages engaged in protecting the mucous membranes from the introduction of an infectious agent, monocytes still prevent the invasion of “outsiders” by absorbing them (in the blood test, relative monocytosis and neutropenia).

One of the results of a general blood test is a study of monocytes, or rather their absolute (MON #, MO #) and relative amount (MON%, MO%). A condition in which the content of these cells exceeds the norm is called monocytosis. What is it, what can be caused, and how to normalize the composition of the blood, read below.

Monocytes are the largest and longest living cells of white blood cells, white blood cells responsible for immunity and purity of blood. What you need to know about monocytes:

  • They are produced in the bone marrow and released into the blood are not fully ripe.
  • After “birth”, monocytes circulate in the blood for only a couple of days. At this moment they are most active.
  • Then they enter the tissue, where they are modified into macrophages.
  • In tissues, macrophages monitor purity together with neutrophils (the remaining leukocytes, much smaller in size).
  • The main function of monocytes is the destruction of pathogenic and foreign cells.

The number of monocytes may increase compared with the norm, this condition is called absolute monocytosis. If for some reason the level of monocytes in the blood is lowered, we are talking about monocytopenia.

  1. Inflammatory and infectious diseases are often an occasion to increase the level of monocytes. The body needs emergency assistance for immunity, so more monocytes are produced. Infectious diseases that cause monocytosis include:

Sometimes the cause of monocytosis in children is teething, but such a violent reaction of the body to this natural process is not so common.

A change in the number of monocytes may be accompanied by other deviations in the composition of the blood. So, for example, monocytosis and granulopenia in a blood test are highly likely to indicate that a viral infection has recently been transmitted by the body. To clarify, you must pass a re-analysis in a couple of weeks. Granulocytes are the same white blood cells, but of a different shape and size.

  1. Autoimmune diseases also relate to the causes of monocytosis in adults. Their mechanism is that, for some reason, the immune system takes the body’s cells as foreign and seeks to destroy it. So the destructive effect comes from the most important defender of health – immunity. Among autoimmune diseases, the most common are:
  • Lupus;
  • Rheumatoid arthritis.
  1. Blood diseases directly affect the content of monocytes. These include:
  • Leukemia;
  • Lymphogranulomatosis;
  • Mononucleosis
  1. Cancerous tumors

Leukemia is a cancer that affects blood and bone marrow function. During it, all the protective abilities of the immune system are under attack.

  1. Other reasons:
  • An individual peculiarity of the organism may cause a slight relative monocytosis in the child;
  • Hereditary pathologies;

The causes of monocytosis with a pathological increase usually reflect the degree of participation of one’s own immunity in anti-inflammatory activity.

Elevated monocytes in the blood are detected with:

  • viral infections (influenza, respiratory disease, mumps, mononucleosis);
  • bacterial and fungal infections (tuberculosis, syphilis, candidiasis);
  • helminthic infestation in children;
  • rheumatic damage to the heart and joints;
  • bacterial septic endocarditis;
  • enteritis, colitis of bacterial and fungal etiology;
  • cases of sepsis;
  • conditions after surgical treatment of appendicitis, gynecological operations;
  • systemic autoimmune diseases (rheumatoid arthritis, sarcoidosis, lupus erythematosus);
  • tumors from the blood germ (lymphogranulomatosis, myelogenous leukemia, thrombocytopenic purpura);
  • malignant tumors.

The increase can be absolute or relative. The determination of the number of these cells is as follows: the total number of leukocytes is taken as 100%, and the content of their species is calculated separately. The norm of monocyte content is 3-11%. This indicator is one of the key components in the white blood cell count. If this indicator in the blood test is increased, then this indicates a certain pathology.

When the level of these cells differs from the norm in a big way, then this phenomenon is called monocytosis. In adult men and women, the cause of this phenomenon can be:

  1. Infectious diseases are the most common reason that the level of these cells in the blood rises. Among them, infectious mononucleosis, various types of fungal, protozoal infections, as well as viral diseases. Moreover, an increase in this indicator indicates that the body has the strength to combat the disease.
  2. Monocytes are also increased during the recovery period after a disease. Moreover, this growth can cause absolutely all diseases, but it will be insignificant.
  3. Severe diseases such as syphilis, tuberculosis, systemic lupus erythematosus, rheumatism, infectious endocarditis can also cause monocytosis.
  4. The postoperative period can cause a condition when monocytes in the blood are elevated.
  5. In some cases, monocytosis can provoke malignant diseases, such as leukemia, lymphogranulomatosis.

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Monocytes (MON) make up from 2 to 10% of all cells of the leukocyte link. In the literature, you can find other names of monocytes: mononuclear phagocytes, macrophages, histiocytes. These cells are characterized by a rather high bactericidal activity, which is especially manifested in an acidic environment. Macrophages rush to the site of inflammation after, but not immediately, but a little later, in order to take on the role of a kind of orderlies and remove all unnecessary products from the body (dead white blood cells, microbes, damaged cells) formed by their arrival during the inflammatory reaction. Monocytes (macrophages) absorb particles of equal size to themselves, they cleanse the inflammatory focus and for this they are called “body wipers”.

High monocyte counts are observed in various pathological processes of an infectious and non-infectious nature. Reduced values ​​are noted, first of all, with inhibition of the myeloid germ of hematopoiesis in the bone marrow.

The main reason for the high values ​​of monocytes in the blood is an adequate response of an organism trying to protect itself by increasing the activity of special cells endowed with the functions of absorbing and digesting pathogens. Elevated monocytes (greater than 1,0 x 10 9 / L) create a picture in the blood test called monocytosis.

  • Some completely physiological conditions (after eating, at the end of menstruation in women, in a child under 7 years of age, etc.);
  • Ingestion (usually in the respiratory tract) of non-infectious (and often inorganic) substances;
  • Infectious processes caused by bacteria (, tuberculosis, syphilis, malaria, brucellosis, typhoid), or viruses (mononucleosis, hepatitis);
  • Some diseases of the hematopoietic system (primarily monocytic and myelomonocytic);
  • Malignant tumor diseases;
  • Collagenoses (,);
  • Stages of recovery after infections and other acute conditions:
  • Surgical operations.


As mentioned above, an increase in the number of monocytes in the blood is physiological and pathological, temporary and permanent. In addition, monocytosis happens:

  • relative – when the percentage of monocytes increases relative to other leukocytes;
  • absolute – when there is an absolute increase in the number of monocytes.

Absolute monocytosis accompanies the immune response to a bacterial infection, at the height of the disease, a short period of relative monocytosis is usually observed.

Infections caused by intracellular pathogens, such as viruses and fungi, on the contrary, are characterized by prolonged relative monocytosis, accompanied by lymphocytosis.

If after a clinical recovery in the blood even a slightly elevated level of monocytes continues to be determined, this is evidence of incomplete recovery, the transition of the infection to a chronic form.

Monocytes (macrophages, mononuclear phagocytes or phagocytic mononuclear cells) constitute an extremely heterogeneous group of cells of the agranulocytic series of leukocytes (non-granular leukocytes) in their manifestation of activity. Due to the special variety of their functions, these representatives of the leukocyte link are combined into one common mononuclear phagocytic system (MFS), which includes:

  • Monocytes of peripheral blood – everything is clear with them. These are immature cells that have only come out of the bone marrow and have not yet performed the basic functions of phagocytes. These cells circulate in the blood for up to 3 days, and then sent to the tissues to mature.
  • Macrophages are the dominant MPS cells. They are quite mature, they are distinguished by the very morphological heterogeneity that corresponds to their functional diversity. Macrophages in the human body are:
    1. Tissue macrophages (mobile histiocytes), which are characterized by a pronounced ability to phagocytosis, secretion and synthesis of a huge amount of proteins. They produce hydralases, which accumulate by lysosomes or escape into the extracellular environment. Lysozyme continuously synthesized in macrophages is a kind of indicator that responds to the activity of the entire MF system (it increases under the action of activators of lysozyme in the blood);
    2. Highly differentiated tissue-specific macrophages. Which also have a number of varieties and can be represented:
      1. Stationary, but capable of pinocytosis, Kupffer cells, concentrated mainly in the liver;
      2. Alveolar macrophages, which interact with the allergens that enter the respiratory air and absorb them;
      3. Epithelioid cells localized in granulomatous nodules (the focus of inflammation) with an infectious granuloma (tuberculosis, syphilis, leprosy, tularemia, brucellosis, etc.) and non-infectious nature (silicosis, asbestosis), as well as with drug exposure or around foreign bodies;
      4. Intraepidermal macrophages (dendritic skin cells, Langerhans cells) – they process the foreign antigen well and participate in its presentation;
      5. Giant multinucleated cells formed from the fusion of epithelioid macrophages.

Most macrophages are in the liver, lungs and spleen, where they are present in resting and activated forms (depending on the circumstances).

Causes of Monocytosis

The circumstances due to which monocytosis appears in children and adults are usually divided according to the nature of the diseases with which it is caused:

  1. Infection. Endocarditis, fungus, virus, infections caused by common and intracellular parasites.
  2. Inflammation with the formation of granulomas. Tuberculosis in various forms, infections transmitted from animals to humans, sarcoidosis, ulcerative colitis, enteritis.
  3. Blood diseases. Acute myeloblastic and monoblastic leukemia, lymphogranulomatosis, chronic monocytic and myelomonocytic leukemia.
  4. Oncology. The occurrence of tumors in different parts of the body.
  5. Surgical intervention. After operations in any part of the body, but to a greater extent after invasion of the pelvic organs.
  6. The rehabilitation period after a serious infectious disease.
  7. Poisoning. Acute intoxication, food poisoning, other poisoning.

Naturally, monocytosis is not a cause, but a consequence of a pathological process. Therefore, treating him does not make any sense. Its occurrence is a completely adequate reaction of the body to the disease. A high monocyte count is a kind of litmus test that helps to determine that some processes are going wrong. So, you need to treat an ailment that provokes an increase in the number of these cells.

Why is there a pathological increase in the level of monocytes in the blood? The currently known causes of monocytosis can be divided into the following groups:

  • infectious (with infectious endocarditis, fungal, viral, protozoal, rickettsial infections);
  • granulomatous (with various forms of tuberculosis, brucellosis, sarcoidosis, ulcerative colitis, enteritis);
  • blood diseases (with acute myeloblastic and monoblastic leukemia, lymphogranulomatosis, chronic monocytic and myelomonocytic leukemia);
  • oncological (with tumors in any organs);
  • systemic (with rheumatoid arthritis, polyarteritis nodosa, systemic lupus erythematosus);
  • surgical (monocytosis in this case is most often observed during surgical interventions on the pelvic organs in women and other operations);
  • post-infectious (increased monocytes seen in the recovery period after a severe infection);
  • toxic (with poisoning with tetrachloroethane or phosphorus).

Monocytes make up from 1 to 8% of all white blood cells, but they cope with extremely important functions:

  • clear the foci of inflammation from dead white blood cells, contributing to tissue regeneration;
  • neutralize and remove from the body cells affected by viruses and pathogenic bacteria;
  • regulate blood formation, help dissolve blood clots;
  • cleave dead cells;
  • stimulate the production of interferons;
  • provide antitumor effect.

Deficiency of white bodies means that the body’s immune status is depleted, and the person is defenseless against infections and internal diseases. But when monocytes are even moderately elevated – this almost always indicates an existing pathology. Permissible is considered a temporary excess of the norm, which is observed in a recovered person who has recently suffered an infection, gynecological surgery, appendectomy and other types of surgical procedures.

If monocytes are elevated in an adult to 9-10%, and in a child up to 10-15%, depending on age, it is important to establish the causes of this phenomenon. Monocytosis, in addition to the common cold, can accompany the most serious diseases.

A short-term increase in the level of monocytes can be a reaction to stress, a longer transient monocytosis can be observed during convalescence after an acute infectious disease or surgery. It can also be caused by the ingestion of foreign substances (not infections) into the airways.

Reasons for increasing the number of monocytes:

  • Absolute monocytosis is a phenomenon when isolated growth of monocytes in the blood is noted, and their concentration exceeds 0,8 * 10 9 / L for adults and 1,1 * 10 9 / L for children under 12 years of age. A similar condition is recorded in some diseases that provoke a specific production of professional phagocytes.
  • Relative monocytosis is a phenomenon in which the absolute number of monocytes remains within the normal range, but their percentage ratio in the bloodstream rises. This condition occurs while lowering the level of other white blood cells.

In practice, absolute monocytosis is a more alarming sign, since it usually indicates serious malfunctions in the body of an adult or child. The relative increase in monocytes is often transient in nature.

In all healthy people, monocytes increase slightly in the first two hours after eating. For this reason, doctors recommend donating blood exclusively in the morning and on an empty stomach. Until recently, this was not a strict rule, and a general blood test with a leukocyte determination was allowed to be done at any time of the day.

Indeed, the increase in monocytes after eating is not so significant and usually does not exceed the upper threshold, however, the risk of incorrect interpretation of the result still remains. With the introduction into practice of apparatus for automatic decoding of blood, sensitive to the slightest changes in the cellular composition, the rules for passing the analysis were revised. Today, doctors of all specialties insist that the KLA give up on an empty stomach in the morning.

High monocytes in women are found in some special situations:

  • Purulent bacterial infections.
  • Aplastic anemia.
  • Oncohematological diseases (late stages).
  • Take some medicines.

Reduced monocytes are less common than an increase in their number in the peripheral blood, and often this symptom is associated with serious diseases and conditions.

This term refers to diseases in which the introduction of pyogenic bacteria and the development of inflammation occur. This usually refers to streptococcal and staphylococcal infections. Among the most common purulent diseases it is worth highlighting:

  • Skin infections: boil, carbuncle, phlegmon.
  • Bone damage: osteomyelitis.
  • Bacterial pneumonia.
  • Sepsis – the entry of pathogenic bacteria into the blood while reducing the overall reactivity of the body.

Some purulent infections tend to self-destruct, others require compulsory medical intervention. In addition to monocytopenia, an increase in the concentration of neutrophilic leukocytes, the cells responsible for a quick attack in the focus of purulent inflammation, is noted in the blood test.

Low monocytes in adults can occur in various forms of anemia – a condition in which a deficiency of red blood cells and hemoglobin is detected. But if iron deficiency and other variants of this pathology respond well to therapy, then aplastic anemia deserves special attention. With this pathology, there is a sharp inhibition or complete cessation of the growth and maturation of all blood cells in the bone marrow, and monocytes are no exception.

Symptoms of aplastic anemia:

  • Anemic syndrome: dizziness, loss of strength, weakness, tachycardia, pallor of the skin.
  • Bleeding of various localization.
  • Decreased immunity and infectious complications.

Aplastic anemia is a severe hematopoiesis disorder. Without treatment, patients die in a few months. Therapy involves eliminating the causes of anemia, taking hormones and cytostatics. A good effect is given by a bone marrow transplant.

In the late stages of leukemia, inhibition of all sprouts of hematopoiesis and the development of pancytopenia are noted. Not only monocytes suffer, but also other blood cells. A significant decrease in immunity, the development of severe infectious diseases is noted. There are causeless bleeding. Bone marrow transplantation is the best treatment option in this situation, and the sooner the operation is performed, the greater the chance of a favorable outcome.

Some medicines (corticosteroids, cytostatics) inhibit the work of the bone marrow and lead to a decrease in the concentration of all blood cells (pancytopenia). With timely assistance and drug withdrawal, bone marrow function is restored.

Monocytes are not just professional phagocytes, janitors of our body, ruthless killers of viruses and other dangerous elements. These white blood cells are a marker of health status along with other indicators of a general blood count. With an increase or decrease in the level of monocytes, you should definitely see a doctor and undergo an examination to find the cause of this condition. Diagnosis and selection of the treatment regimen is carried out taking into account not only laboratory data, but also the clinical picture of the identified disease.

The main thing is not to panic. First of all, take a blood test again, in another laboratory. This is important; be sure to not contact a center using the services of the same laboratory as the previous one. Sometimes the problem is the human factor, poor-quality reagents, or faulty equipment.

If the test results are confirmed, consult a doctor for an in-depth examination.

In such cases, appoint:

  • immunogram;
  • blood test for tumor markers;
  • blood test for autoimmune diseases;
  • puncture of cerebrospinal fluid, if necessary, bone marrow analysis.

Of course, these studies are only prescribed if the doctor does not find signs of an infectious or bacterial nature in your disease. Fortunately, this happens infrequently.

Monocytosis is not treated. Only the underlying disease is treated, and this symptom resolves on its own.

If the virus called it, then you will be treated with antiviral and interferons, with a bacterial nature – a course of antibiotics. More complex systemic diseases are treated comprehensively. In any case, you should carefully follow the doctor’s recommendations, and the condition will improve soon.

  • An increase in neutrophils, especially those of stabs (neutrophilia). This kind of process indicates an acute inflammatory disorder and is most pronounced in purulent processes (meningitis, abscesses and phlegmon, erysipelas).
  • An increase in lymphocytes (lymphocytosis), a condition that is characteristic of a particular series of infections. If lymphocytes are elevated in an adult, what does this mean?
  • An increase in eosinophils (eosinophilia) indicates the presence of allergic diseases and syndromes, parasitic diseases, skin diseases, collagenoses, many serious blood diseases, specific inflammatory diseases.
  1. Cancerous tumors
  1. Other reasons:

As a summary

If the absolute content of monocytes in the blood is increased, you need to:

  • see a doctor;
  • pass the examination;
  • identify the cause;
  • start a course of treatment.

By the time of its completion, the number of monocytes should return to normal. If this does not happen, then there is another pathology in the body.

The result of a general blood test that identifies this ailment may not be correct, so double-check again before starting the search for the disease.

Most often, monocytosis is a consequence of prolonged bacterial inflammation, which responds well to antibiotic treatment. Do not panic ahead of time. However, it’s also not worth relaxing: it can be a symptom of a dangerous disease, so self-medication attempts are unacceptable here!

Some features of monocytes

If monocytosis in a child persists for a long time, it is necessary to conduct an examination, first of all, in order to exclude malignant blood diseases and systemic diseases.

The vast majority of monocytes originates in the bone marrow from a multipatent stem cell, and from a monoblast (ancestor), it passes through the stages of promyelomonocyte and promonocyte. A promonocyte is the last stage before a monocyte, the immaturity of which is indicated by the paler loose nucleus and the remnants of a nucleol. Promonocytes contain azurophilic granules (by the way, mature monocytes also have them), but nevertheless, these cells belong to the agranulocyte series, since granules of monocytes (lymphocytes, immature cells, histogenic elements) are stained with azure and are a product of protein cytoplasmic discolloidosis. A certain (small) number of monocytes is formed in the lymph nodes and connective tissue elements of other organs.

The cytoplasm of mature monocytes contains various hydrolytic enzymes (lipases, proteases, verdoperoxidase, carbohydrase), other biologically active substances, however, the presence of lactoferrin and myeloperoxidase can be detected only in trace amounts.

The body is able to accelerate the production of monocytes in the bone marrow, unlike other cells (for example, neutrophils), only two to three times. Outside the bone marrow, all cells belonging to phagocytic mononuclear cells proliferate very weakly and to a limited extent; they are replaced by cells that reach the tissues only due to monocytes circulating in the blood.

Once in the peripheral blood, monocytes live in it for no more than 3 days, then move to the surrounding tissues, where they finally mature into histiocytes or various highly differentiated macrophages (Kupffer liver cells, alveolar macrophages of the lungs).

AgeThe norm of monocytes,%
1-15 days5 – 15
15 days – 1 year4 – 10
1-2 years3 – 10
2-15 years3 – 9
Older than 15 years3 – 11

The normal value of monocytes in women and men does not differ. The level of these blood cells is gender independent. In women, the number of monocytes increases slightly during pregnancy, but remains within the physiological norm.

In clinical practice, not only the percentage, but also the absolute content of monocytes in a liter of blood is important. The norm for adults and children is as follows:

  • Up to 12 years old – 0,05-1,1 * 10 9 / l.
  • After 12 years – 0,04-0,08 * 10 9 / L.


The main method for diagnosing monocytosis is a clinical (general) blood test. Since monocytes are one of the forms of leukocytes, their number is determined by counting the leukocyte formula. The international designation of leukocytes is WBC (white blood cells, white blood cells), monocytes in the leukocyte formula are designated as MON (monocytes).

Monocytosis is diagnosed when the content of monocytes in the blood exceeds 1–11% or 0,8 x 109 / L.

After detecting an increased number of monocytes in the blood, a diagnostic search is conducted in the direction of the cause of this condition. It is necessary to take into account previously transferred infectious diseases, as well as any existing symptoms. If necessary, a comprehensive examination is carried out, including additional blood tests, imaging techniques (for example, magnetic resonance imaging or computed tomography of the lymph nodes), bone marrow puncture, lymph node biopsy, etc.

Monocytosis in some diseases can serve as a prognostic sign. So, it is known that a significant increase in the number of intermediate monocytes in atherosclerosis increases the risk of cardiovascular events.

An unmotivated persistent increase in the number of monocytes may be a harbinger of acute leukemia, which occurs several years later. The reason for this phenomenon has not yet been established.

Causes of a decrease in blood monocytes

Monocytosis level is measured in two indicators:

  1. absolute, showing the number of cells per liter of blood, with a norm in adults up to 0,08 * 109 / l, in children – up to 1,1 * 109 / l;
  2. relative, showing whether monocytes are increased in relation to other leukocyte cells: the limit is considered to be 12% in children under 12 years old, and 11% in adult patients;

To test the blood for the content of monocytes, an extended analysis is prescribed with a detailed decoding of the leukocyte formula. Capillary blood donation (from the finger) is carried out in the morning, on an empty stomach. Drinking before analysis is also not recommended.

Purulent and inflammatory processes in the body are common reasons that monocytes are elevated. If primary tests record that monocytes are significantly increased with normal white blood cell counts or a drop in their overall level, additional studies are needed. Separated from the rest of the white bodies, elevated monocytes are quite rare, so doctors recommend repeating the analysis after some time to exclude erroneous results. In any case, you should not independently decipher the analysis: only a specialist can correctly interpret the resulting figures.

The total number of monocytes is displayed in the composition of the leukocyte formula and is included in the general blood test (OAC). Material for research is taken from a finger or from a vein. Blood cells are counted manually by a laboratory assistant or using special devices. The results are issued on a form, which must indicate the standards adopted for a particular laboratory.

Complete blood count (KLA) is currently the most popular screening test, which was required to be taken, probably, to any person.

It is constantly used as a screening, one of the most important primary research methods for a wide variety of pathological conditions, therefore it is he who is used to determine the level of these cells.

This analysis allows you to determine the total number of all white blood cells and the proportional ratio of various forms among them, this is called the definition of a white blood cell formula.

There is no specific preparation for the examination. It is advisable to take an analysis in the morning on an empty stomach or two hours after a meal.

They represent a special category of leukocytes and are determined both relative (as a percentage of the total number of leukocytes), and in absolute quantity.

A general blood test allows you to calculate the relative number, but there are special methods that allow you to determine the absolute number of cells per unit volume (usually a liter of blood). Moreover, the number of cells has no sexual dependence, sometimes even age.

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The norms for women and men are practically the same. The determination of the absolute (abs.) Value per 1 liter of blood is carried out according to a general analysis and study of a stained smear. The content of monocytes relative to the total amount of leukocytes is calculated as a percentage and is called the level.

Both indicators are important for evaluating the result. With a sharp fluctuation in the number of other cells included in the leukocyte formula, the level of monocytes can change (above the norm or decrease). Although their absolute value will remain unchanged.

An analysis of the connection with the age category showed an increased level in children under 6 years of age compared with the content in an adult.

For adults, the normal absolute value is considered to be values ​​from zero to 0,08×10 9 / l, for a child from 0,05 to 1,1 x 10 9 / l is permissible.

Any indicator that exceeds the upper limit is called monocytosis and has its own physiological and pathological causes.

Other reasons why monocytes in the blood can be elevated are divided into several groups:

  1. Systemic infectious diseases: tuberculosis, brucellosis, sarcoidosis, syphilis and others.
  2. Blood diseases: acute leukemia, chronic myelogenous leukemia, polycythemia, thrombocytopenic purpura, osteomyelofibrosis.
  3. Autoimmune conditions: systemic lupus erythematosus, rheumatoid and psoriatic arthritis, polyarthritis.
  4. Diseases of the rheumatological profile: rheumatism, endocarditis.
  5. Inflammation of the gastrointestinal tract: colitis, enteritis and others.
  6. Oncology: lymphogranulomatosis, malignant tumors.

Timely revealed increased content of phagocyte cells plays an important role in the diagnosis of these diseases. The analysis that determined monocytosis is the reason for a deep examination: if you do not establish the reasons for the increase in monocytes in the blood, you can miss the development of deadly conditions.

Monocytosis level is measured in two indicators:

  1. absolute, showing the number of cells per liter of blood, with a norm in adults up to 0,08 * 109 / l, in children – up to 1,1 * 109 / l;
  2. relative, showing whether monocytes are increased in relation to other leukocyte cells: the limit is cons >

Purulent and inflammatory processes in the body are common causes of absolute monocytosis. If primary tests record that monocytes are significantly elevated with normal white blood cell counts or a drop in their overall level, additional studies are needed. Separated from the rest of the white bodies, elevated monocytes are quite rare, so doctors recommend repeating the analysis after some time to exclude erroneous results. In any case, you should not independently decipher the analysis: only a specialist can correctly interpret the resulting figures.

Monocytes are one of the largest blood cells that belong to the group of leukocytes, do not contain granules (they are agranulocytes) and are the most active phagocytes (able to absorb foreign agents and protect the human body from their harmful effects) of peripheral blood.

They perform protective functions – they fight against all kinds of viruses and infections, absorb blood clots, preventing the formation of blood clots, and exhibit antitumor activity. If the monocytes are reduced, then this may indicate development (doctors pay special attention to this indicator during pregnancy), and an increased level indicates the development of infection in the body.

If we talk about the quantitative content of monocytes in the blood, the norm of this indicator should be in the range of 3–11% (in a child the number of these cells can fluctuate in the range of 2–12%) of the total number of leukocyte blood elements.

Basically, doctors determine the relative quantitative content of these elements (this is done), but if serious bone marrow disorders are suspected, an analysis is carried out on the absolute content of monocytes, the poor results of which should alert any person.

Women (especially during pregnancy) always have a little more leukocyte cells in their blood than men, in addition, this indicator can vary depending on age (children may have more).

Monocytes are one of the important components, the main components of which give the doctor a general idea of ​​the patient’s health status. Both the increase and decrease in monocytes, which can be observed in children and adults, indicates the development of some kind of internal disturbance. Monocytes are especially carefully examined when examining women “in position”, because during pregnancy, the immune system directs all its forces to maintaining the health of the fetus, so a variety of bacteria enter the body of a woman, with which all types of lymphocytes are constantly fighting.

  • pregnancy and childbirth (with regard to pregnancy, in the first trimester of women in the blood there is a sharp decrease in the number of all formed blood elements, including those that are part of the leukocyte formula, and the body is depleted during childbirth);
  • depletion of the body (special attention should be paid to lowering monocytes in the blood of children, because if their number drops against the background of depletion of the body, then the work of all internal organs and systems is disrupted);
  • taking chemotherapeutic drugs (causes the development of aplastic anemia, most often found in women);
  • severe purulent processes and acute infectious diseases (for example, typhoid fever).

If it is found that monocytes are lowered in the blood of one of the children, then such a child is assigned additional tests for the presence of infection in the body, as well as impaired immune or hematopoietic system.

If, after receiving the analysis, it is found that the monocytes are elevated in an adult, then you must immediately consult a doctor in order to conduct additional tests (in fact, in the case of the development of the same condition in children, you must do the same). It is worth saying that treating conditions in which in the body of children or adults there is a change in the number of leukocyte blood elements is pointless. First, the doctor determines the cause of the development of this disease, and then prescribes the necessary pharmaceutical preparations for its treatment.

Absolute and relative monocytosis – causes, symptoms, treatment

It is impossible to talk about the treatment of monocytosis without eliminating the cause of this condition – there are no medicines or folk recipes to reduce the level of monocytes. To restore normal blood counts, it is necessary first of all to conduct an in-depth diagnosis, determine the site of inflammation or infection, and on the basis of these data, prescribe treatment procedures.

In order for the diagnosis of monocytosis, especially when it comes to monocytosis in a child, to give accurate results (in children, the level of leukocytes varies depending on the age and characteristics of the body), it is recommended to take blood tests strictly on an empty stomach.

The treatment of monocytosis depends on what caused it. In some cases (the recovery period after an infectious disease or surgery, physiological monocytosis in women or children), nothing needs to be treated, however, it may be necessary to re-conduct a clinical blood test in order to exclude a possible erroneous interpretation of monocytosis as physiological.

If a persistent increase in the level of monocytes is noted after an infectious disease, this is an indicator of the chronicity of the infection, which means that there may be a need for an additional course of anti-infection therapy.

The treatment of systemic diseases (collagenoses, vasculitis) depends on the specific diagnosis, usually it consists in the course of taking glucocorticoids, aminoquinoline derivatives, etc. The treatment of these diseases is usually lifelong – supporting during periods of remission and active during periods of exacerbation.

If monocytosis is caused by an oncological pathology, namely, a malignant lesion of the blood, the treatment consists of chemotherapy, i.e., several courses of systemic drugs with a cytostatic effect, sometimes in combination with radiation therapy.

After completion of treatment, a control blood test is performed to confirm the normalization of the number of monocytes in the blood.


Prevention of monocytosis is to prevent the diseases that caused it. The risk of developing infectious diseases that cause an increase in the number of monocytes can be reduced if measures are taken to reduce the likelihood of contact with the infection on the one hand, and increase the body’s resistance on the other. To do this, you must:

  1. Carefully adhere to the rules of hygiene.
  2. Minimize visits to public places during seasonal and other epidemics.
  3. Maintain optimal sanitary and microclimatic conditions in the home.
  4. Adhere to a healthy lifestyle. This concept includes a reasonable mode of work and rest, regular moderate physical activity and proper nutrition.
  5. Seek timely medical attention in case of symptoms of any disease.
  6. Fully undergo treatment for existing diseases, strictly adhering to medical prescriptions in order to avoid the transition of diseases into a chronic form, which is more difficult to treat.

What is monocytosis? Its causes and symptoms

Monocytosis refers to those conditions whose clinical indicators cannot be called pronounced symptoms. As a rule, the fact of an increase in the number of monocytes is detected in the process of laboratory blood tests.

Observing parents may suspect monocytosis in their child if they notice that he has become less active, more often tired, causelessly acting up. Such behavior with elevated monocytes is not often observed, but it should attract the attention of parents to the well-being of their child. This is important for the early detection of the true causes of this condition, which will allow treatment to begin as soon as possible.

The norm of monocytes for children

In adults, an increase in monocytes can be manifested by the following symptoms:

  • fatigue, general weakness;
  • subfebrile body temperature (prolonged increase in temperature from 37 to 38 degrees);
  • joint pain;
  • a feeling of soreness.

Similar symptoms are found in most infectious (including respiratory) diseases, so talking about diagnosis only on the basis of detected monocytosis is inappropriate.

This condition – monocytosis, can be divided into several types:

  1. Absolute monocytosis: it can be diagnosed when the number of cells themselves becomes higher than 0,12-0,99 * 10 9 / L.
  2. Relative monocytosis: a pathological or physiological condition in which the total part of monocytes becomes higher than 3-11% of the total number of leukocytes.

Moreover, the absolute numbers of monocyte content can remain within the normal range, but their level in the general leukocyte formula will be increased, which means that the number of monocytes will be the same, but the number of other types of leukocytes will be reduced. More often this is observed with a decrease in the number of neutrophils (neutropenia) and a decrease in the number of lymphocytes (lymphocytopenia).

Monocytosis during pregnancy: in women bearing a fetus, a not too high increase in the sum of leukocytes and monocytes is considered a physiological reaction of the body to a “foreign” body. And one must always bear in mind that absolute monocytosis in pregnant women should be necessarily corrected, in contrast to relative.

Monocytosis is not a disease, but a symptom of the underlying disease. Therefore, the picture of monocytosis will depend on the disease itself.

In the absence of any symptoms of the disease, it can be recognized by non-specific signs:

  • chronic fatigue,
  • fast fatiguability
  • reduced performance
  • general weakness
  • drowsiness,
  • constant low-grade fever.

These signs may indicate a variety of diseases. During pregnancy, they are physiologically determined.

In any case, you need to see a doctor and take tests.


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It is difficult to isolate specific signs of the presence of monocytosis in a patient. Still, an increase in their number is mostly a consequence, not a cause. Often the symptoms characteristic of monocytosis can indicate a completely different ailment. Therefore, there are no special signs inherent exclusively in the fact of an increase in the content of immune cells in the blood. Confirm this pathology can only laboratory blood tests.

The pathology in children is much slower than in adults. Because the inflammatory process does not immediately provoke an increase in immune cells – this indicator rises gradually. If we consider the features that indicate the large presence of monocytes, then we can distinguish the following symptoms:

  1. Fast fatiguability. It is characteristic of both adults and children. Manifestation of weakness of the body, loss of strength, decreased activity always suggests that the energy resources produced by the body are aimed at combating foreign cells.
  2. Fluctuations in body temperature in an unhealthy range. For children, for example, high body temperature is characteristic, but it should be in the range from 36 to 37 degrees. As for adults, for them a temperature above 36.6 already means the course of the inflammatory process in the body.
  3. General painful condition, joint pain. If an adult understands when he is feeling unwell, then the child often does not at all identify any changes in his general state of health with the disease. Therefore, the child begins to act up, ceases to run, jump, he loses his appetite.

Monocyte Enhancing Factors

  • indicate the stage of the disease;
  • determine the forecast;
  • confirm the type of pathogen;
  • determine the degree of loss of immunity.

Consider the most common blood cell reactions.

When monocytes and lymphocytes are elevated, acute viral infection should be suspected: influenza, respiratory disease, measles, rubella, chickenpox. Against this background, a decrease in neutrophils is observed.

It is clear to the doctor that antiviral agents must be prescribed.

Different types of white blood cells look like under a microscope

A distinctive symptom in patients is a prolonged painful dry cough in the absence of wheezing in the lungs and other clinical manifestations.

Monocytes basophils

Basophils are fast-responding cells, they manage to approach the site of infection, while others are still “pondering the information received.” With an increase in monocytes and basophils, it is necessary to exclude the effect of prolonged treatment with hormonal agents.

The growth of basophils is always accompanied by an increase in macrophages and lymphocytes. They act by producing serotonin, histamine and other substances that enhance inflammation.

When monocytes and neutrophils are elevated, you need to think about acute bacterial infection. At the same time, the level of lymphocytes decreases. The patient has an increase in temperature, a wet cough, a runny nose with purulent discharge from the nose, while listening to a lot of wheezing in the lung tissue.

All cells of the immune system help and replace each other. Sharp and prolonged level deviations require careful examination of the hematopoietic system to exclude malignant diseases.

Monocytes belong to leukocyte cells, the main purpose of which is to capture and neutralize foreign elements in the bloodstream. The phagocytic action of these bodies allows you to maintain the human immune defense. An increase in monocytes always indicates that there is a struggle with pathogenic agents in the body.

Briefly about monocytes

Non-granular white blood cells (monocytes, macrophages, phagocytic mononuclear cells, mononuclear phagocytes) are the largest representatives of the white blood cell community. This value compared to other cells is explained by their functional responsibilities – they absorb bacteria, damaged and “dead” cells, and the AG-AT immune complexes, in general, relieve the body of the effects of the inflammatory reaction and are called “orderlies” or “janitors”.

However, they show all their abilities in full force when they become macrophages. Monocytes – cells that are not fully matured, they circulate in the blood for three days, and then sent to the tissues, where they mature and turn into macrophages, finally become fixed in the “profession”. Thus, mononuclear phagocytes are a community of monocytes and tissue macrophages: the former are actively moving in the bloodstream, the latter are inactive and are mainly located in tissues.

Monocytes belong to the system of mononuclear phagocytes. In general, they just don’t call it (the system): the system of phagocytic mononuclear cells, the macrophage system, the mononuclear phagocytic system – MPS (it was formerly called the reticuloendothelial system – RES).

Due to the fact that phagocytosis is mentioned in one of the names in one way or another, doctors interpret the increase in the number of these cells in a blood test (monocytosis) as a protective reaction, the body’s response to the penetration of pathogenic bacterial flora. In addition to phagocytic function at the level of cellular immunity, monocytes interact with other non-granular representatives of the leukocyte link – lymphocytes, and, accordingly, do not remain aloof from humoral immunity.

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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.
The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.