What Causes Neutrophilia?

Neutrophilia is a term used to describe a condition where there are too many neutrophils circulating in the blood. Between forty and sixty percent of all white blood cells in the body are neutrophils. Neutrophils are the first to respond to foreign pathogens that invade into the body. When cells around the body become damaged, chemokines are released and attract neutrophils to the site. Neutrophils mediate foreign pathogens by undergoing the processes of endocytosis and phagocytosis or engulfing the pathogens. Once engulfed, specialized enzymes in neutrophils induce the destruction of the pathogen. A healthy individual typically has between 2500 and 7500 neutrophils per microliter of blood. Neutrophilia has numerous causes that can be classified into three groups. Reactive neutrophilia is an active response to stress or infection. Proliferative neutrophilia happens when some mechanism causes the bone marrow to overproduce neutrophils. Demargination occurs when specific neutrophils detach from the blood vessel lining and remain circulating in the blood.

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Arthritis

Individuals affected by arthritis may develop neutrophilia as a result of their inflammatory condition. Neutrophils are the main type of white blood cell that contributes to the trigger and progression of arthritis in affected individuals. Neutrophils play this role by their release of molecules that are toxic to other living cells in the body and molecules that mediate responses between macrophages and lymphocytes. Neutrophils in individuals who have arthritis have different cellular properties than those in healthy individuals. Rheumatoid arthritis patients have neutrophils with delayed cellular death and a more sophisticated ability to generate reactive oxygen species, activate and deactivate certain genes, and expression of high-affinity FcY receptors on the cell membrane. Arthritis patients also have an immune system that exhibits a defect in their function of neutrophil clearance due to the autoimmunity nature of arthritis. In some cases of autoimmune disorders such as arthritis, neutrophils may be the point of supply of the specific autoantigens or antibodies that propel the underlying mechanisms that result in the autoimmune disease. It is a combination of neutrophil apoptosis delay, clearance defects of neutrophils, and other abnormal properties of neutrophils that can cause an individual with arthritis to also be affected by neutrophilia.

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Certain Forms Of Leukemia

An individual's neutrophilia can be caused by certain forms of leukemia or blood malignancies. Chronic myeloid leukemia is a malignancy that begins in an affected individual's bone marrow or blood-forming tissues. In the beginning stages of this type of leukemia, the bone marrow produces an excess amount of white blood cells. However, myeloblasts or immature white blood cells begin to accumulate in the patient's bone marrow and blood, resulting in a decrease of red blood cell and platelet production. Acute myeloid leukemia also causes neutrophilia, but on a much quicker timeline than its chronic form. Myelofibrosis is a chronic form of leukemia where an affected individual's bone marrow is replaced by scar tissue. This results in an excess of red and white blood cells that do not fully mature and cannot function as healthy cells. Chronic neutrophilic leukemia is a slow-growing malignancy of the bone marrow where it makes too many neutrophils, a specific type of white blood cell. Acute neutrophilic leukemia also causes neutrophilia but grows at a much faster rate.

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Infections

Infections that are the result of staphylococci, streptococci, gonococci, pneumococci, meningococci, Escherichia coli, Actinomyces species, and Pseudomonas are known to trigger neutrophilia. Types of fungi known to cause neutrophilia consist of Candida albicans and coccidiosis immitis. Viruses known to cause individuals to develop neutrophilia include rabies, herpes zoster, varicella, poliomyelitis, smallpox, and rickettsia. Parasites can also cause neutrophilia, but typically less often than viruses and bacteria. An individual who has an abscess, appendicitis, meningitis, tonsillitis, and peritonitis can also experience neutrophilia as a result of their infection. Because neutrophils are the first white blood cells in the immune system to reach the site of cellular damage, they can be overproduced in patients when their infection induces such a reactive process in the body. A mild elevation in neutrophils during acute infection is beneficial, but anything greater can cause the blood to become too thick and produce serious complications.

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Removal Of The Spleen

An individual who has undergone removal of their spleen may develop neutrophilia as a complication of their operation. The spleen and liver are capable of producing certain blood cells when the bone marrow is not making enough. At the same time, the spleen is a key component in the process of neutrophil removal and destruction of dead and dying neutrophils from the body. There are only three tissues in the body that can perform neutrophil clearance, including the spleen, liver, and bone marrow. All three of these contribute to the neutrophil clearance process equally in most healthy individuals. However, some individuals have had to have their spleen removed due to several different conditions and diseases. Without the spleen, the liver and bone marrow are left to perform the job of clearing out neutrophils marked for apoptosis and destruction. The removal of the spleen requires at least a minimally invasive procedure that results in post-operation inflammation. This process causes an increase in the production of neutrophils, with only two-thirds of the healthy neutrophil clearance functionality left. Neutrophilia is often the result of this mechanism.

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Reaction To Certain Medications

An individual's reaction to certain medications can cause them to develop neutrophilia. Beta-adrenergic agonists are bronchodilators, which function to loosen the muscles lining an individual's airways. These medicines are typically used to treat individuals affected by bronchitis, asthma, emphysema, and other lung conditions. Neutrophilia is an uncommon adverse side effect of beta-adrenergic agonists. Corticosteroids exhibit a similar mechanism that causes neutrophilia but is typically used to treat other issues such as autoimmune disorders, skin conditions, and for the prevention of donor organ transplant rejection. Epinephrine is a medication used to treat anaphylaxis, cardiac arrest, and other emergent conditions. This medicine causes the neutrophils embedded in the blood vessel walls to enter and populate the bloodstream, resulting in neutrophilia.

Granulocyte colony-stimulating factor is a medication used in cancer patients who have a low neutrophil count following their treatment. This medication stimulates the production and release of white blood cells from the bone marrow, and therefore, may cause neutrophilia. Heparin can cause neutrophilia because it causes increased activation of neutrophilic components. Lithium, a medication used to treat some psychiatric disorders, is also known to cause neutrophilia by stimulating the production and release of neutrophils from the bone marrow.