There are six types of neutrophils depending on the stage of their maturation. Immature types include myeloblasts, promyelocytes, myelocytes, metamyelocytes and band cells. The final stage of development is segmented neutrophils (mature cells with a formed nucleus, divided into several segments).
Even at the stages of their initial development, neutrophils are able to resist infection, although mature segmented cells cope with this task much more effectively.
In blood tests of people suffering from severe infectious diseases, immature forms of neutrophils can be detected. This is explained by the fact that in the fight against pathogenic microorganisms, segmented cells die too quickly, and therefore the body is forced to use cells that are not fully mature. But in the blood of a healthy person, predominantly mature neutrophils are found, since they cope well with their task with virtually no help from their young brothers.
Figure 1. Phagocytosis. Image: mikrostoker/Depositphotos
Blood test for neutrophils
To determine the level of neutrophils, a complete blood count is used. To designate neutrophils on the analysis form, the Latin abbreviation NEUT is used, which can be expressed either in absolute (cell content per liter of blood, for example 0.04-0.3 × 109) or as a percentage. For general analysis, capillary blood is usually used. The biomaterial is collected from a finger after puncture with a scarifier. Sometimes blood is drawn from a vein - much depends on the methods the laboratory uses.
Indications for analysis
A general blood test is the most common hematological test, so the range of indications for its use is wide. Neutrophils are a type of white blood cell whose main task is to destroy pathogenic microorganisms. Therefore, the main goal of the analysis for the content of neutrophils is to identify potentially dangerous conditions accompanied by infectious and inflammatory processes. In other words, a blood test for neutrophils can be informative both for colds and for kidney or liver diseases.
Preparing for analysis
The study is carried out in the morning on an empty stomach, since food intake causes an increase in the number of neutrophils in the blood. Dinner on the eve of the test is allowed no later than eight o'clock in the evening. 2 days before the study, the patient should follow the following preparation rules:
- stop drinking alcohol;
- limit the consumption of spicy, fried and fatty foods;
- Avoid heavy physical activity and nervous stress.
The morning before the test you should not smoke. It is allowed to drink pure still water.
Figure 2. Preparation for donating blood for analysis.
Normal levels of neutrophils in the blood
The number of neutrophils in the blood is approximately 40-70% of the total leukocyte mass in both men and women.
When conducting research, experts primarily pay attention to the content of neutrophils at the middle and full stages of maturation, that is, band and segmented forms. Young cells are of interest if the development of the spread of inflammatory processes is suspected. The table shows the leukocyte formula, which reflects, among other things, the number of neutrophils. Table 1. Leukocyte formula with the number of neutrophils
| Index | × 10x9/l | Share as a percentage of the number of leukocytes | |
| Neutrophils | segmented | 2.0 – 5.5 | 40 — 70 |
| stab | 0.4 – 0.3 | 1 — 5 | |
| Basophils | Within 0.062 | Within 1.0 | |
| Eosinophils | 0.02 – 0.3 | 0.5 — 5 | |
| Lymphocytes | 1.0 – 3.2 | 17 — 38 | |
| Monocytes | 0.07 – 0.5 | 3 — 12 | |
In children of the first year of life, the number of band neutrophils can reach five, then the maximum value is limited to four, as in adults. The smallest number of segmented neutrophils is observed in children 4-5 years old (35-55%). In other age groups it varies between 40-70%.
Infections:
Every person has experienced purulent-inflammatory processes at least once in their life. Most often, we observed them in the most harmless form - in the form of pimples and pustules on the skin, but this can also be another, more serious and difficult process.
Did you know that pus is dead white blood cells? And not just leukocytes, but those that have the ability to phagocytose: destroy, “devour” harmful particles. In the fight against the aggressor, they die and cell by cell form a focus of inflammation. One drop of pus contains millions of leukocytes, and these are mainly neutrophils. And there are diseases when up to several tens of milliliters, up to a liter of pus and even more accumulate in the body of patients! Can you imagine the loss of neutrophils the body suffers?
But immunity will not allow itself to be offended. In response to the attack of microbes, it will reproduce and release new white blood cells into the blood, so that in general their number may even increase above normal, despite the fact that the body is continuously producing pus. So neutrophilia is a sign of almost any infectious disease caused by bacteria and fungi. Pneumonia, tonsillitis, soft tissue abscesses, sinusitis... The list can be very long, and in all such cases, neutrophils in the blood are elevated in any patient.
If neutrophils are elevated in a child or adult, and the reason for this is an infectious process, then their different types increase unequally. Blood tests evaluate two main types of neutrophils: band and segmented. In bacterial and fungal diseases, mainly band neutrophils increase. These are young forms of cells, and an increase in their number allows us to draw obvious conclusions that the bone marrow is actively working and producing them intensively.
By how much a person's neutrophils are elevated, one can judge the severity of the disease. If the increase does not exceed twofold, this usually indicates the presence of an obvious infection. But sometimes it happens that due to neutrophils, the total number of leukocytes increases by 5-10 times. This could be a sign of a very serious condition - blood poisoning, or sepsis.
Causes of increased neutrophils in the blood
Elevated neutrophil levels can indicate a wide range of illnesses and injuries. Very often, the cause of an increase in neutrophils in the blood is infectious processes of bacterial origin, which can be either focal or generalized (spread throughout the body).
Reasons for increasing the level of neutrophils in the blood:
- upper respiratory tract infections (laryngitis, pharyngitis, sore throat);
- pneumonia;
- kidney diseases;
- diseases of the cardiovascular system;
- local purulent-inflammatory foci (abscesses, abscesses);
- viral diseases (measles, mumps, chickenpox, rubella, etc.);
- oncological diseases;
- taking hormonal medications;
- infections of bacterial origin (dysentery, tuberculosis, cholera, anthrax, etc.);
- poisoning with toxic substances;
- processes of tissue necrosis (gangrene, myocardial infarction, major burns);
- injuries of large organs;
- fractures;
- damage to the skin (cuts, abrasions, etc.);
- gout;
- sepsis (blood poisoning).
Eating canned foods can also cause an increase in neutrophils. This applies to those products in which there are no longer living bacteria left, but the toxic products of their vital activity have been preserved.
Symptoms and signs of leukocytosis
An increase in the level of leukocytes cannot be considered as an independent disease. It always develops against the background of another disease, and therefore does not have its own symptoms and clinical manifestations. Often, in the early stages, leukocytosis in men and women has no symptoms; a person may even think that he is completely healthy. However, there are a number of symptoms that you should pay attention to. Especially if a person cannot explain their nature, for example:
- elevated body temperature for a long time;
- frequent bruising and bleeding;
- general weakness, feeling of malaise;
- frequent dizziness or fainting;
- tingling and pain in the limbs;
- loss of appetite or weight loss for no apparent reason.
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Causes of low levels of neutrophils in the blood
A decrease in the level of neutrophils in the blood is called neutropenia. The cause of this phenomenon can be diseases of various natures, as well as taking various medications.
Reasons for decreased neutrophil levels:
- infectious diseases (viral hepatitis, typhus, influenza, mononucleosis, etc.);
- autoimmune diseases (rheumatoid arthritis, systemic vasculitis, Crohn's disease, etc.);
- radiation sickness;
- blood diseases (leukemia, hemolytic and dyserythropoietic anemia).
Separate mention should be made of medications: taking them can also cause neutropenia. This is a very broad group of medications, which includes:
- NSAIDs (non-steroidal anti-inflammatory drugs: analgin, amidopyrine);
- antibacterial drugs (cephalosporins, penicillins);
- drugs to lower sugar (chlorpropamide);
- thyreostatic agents (propylthiouracil, Mercazolil);
- antimalarial drugs of synthetic origin (hydroxychloroquine);
- sulfonamides (sulfapyrazone; sulfasalazine);
- cytostatics (chlorambucil, methotrexate);
- antivirals (ganciclovir, zidovudine).
Figure 3. Blood cells in a healthy person and with neutropenia. Image: Sakurra/Depositphotos
Diagnosis of leukocytosis
The diagnosis of leukocytosis is established based on the results of a clinical blood test. An appointment with a general practitioner takes place in two stages: taking an anamnesis and examining the patient. After analyzing the data obtained, the doctor prescribes additional studies to identify and confirm the disease that caused leukocytosis.
Let's consider the types of possible research.
- Detailed blood test and biochemical blood test. Leukocytosis is determined in the blood smear for the presence of toxic granularity of neutrophils, as well as atypical mononuclear cells.
- Detection of the pathogen using bacterial culture of blood, urine, and sputum. Identification of the pathogen will allow the exact cause to be determined and effective treatment to be prescribed.
- Allergy diagnostics. To confirm the allergic nature of leukocytosis, studies measure the level of immunoglobulin E using ELISA. Skin and provocative allergy tests may also be performed.
- Radiography. This method can be used to examine chest organs, joints, etc.
- Ultrasound. An effective diagnostic method for a large number of diseases. Ultrasound helps to identify, for example, an increase in the size of the kidneys, compaction of the pyelocaliceal system, it is also important for identifying vegetation on the valves, etc.
Research in our clinic is carried out using the most modern equipment, as quickly as possible.
Consequences of deviation of neutrophils from the norm
A change in the level of neutrophils in the blood is a signal from the body about the presence of inflammatory diseases, injuries or poisoning. Therefore, it is necessary to accurately determine the cause of the increase or decrease in neutrophils in order to begin treatment in time or eliminate the provoking factor. If this is not done on time, the consequences can be severe (even death). The greatest danger among possible causes is infectious diseases of a bacterial nature, as well as processes of local suppuration and necrotization (death) of tissue.
Physiological causes of neutrophilia:
For the first time, a person experiences an increase in neutrophils at an age he does not remember. During infancy, all people experience neutrophil-lymphocytic crossover. Neutrophils and lymphocytes either increase or decrease relative to each other. In some periods, neutrophils are increased in a child to 80% or more, although the generally accepted norm is a lower value.
Other physiological reasons for the increase in these cells are equally characteristic of children and adults. In particular, these reasons include intense physical activity: a person who has moved a lot has a high level of neutrophils in the blood for several hours afterward.
Also, upward fluctuations in the indicator are typical for the time after eating. This is one of the reasons why it is recommended to come for a general blood test on an empty stomach. Otherwise, doctors may mistakenly explain a falsely elevated neutrophil count by the presence of some disease in the patient.
How to reduce the number of neutrophils in the blood
To reduce the number of neutrophils in the blood, it is necessary to influence the cause of this phenomenon, since there are no separate ways to eliminate it. If the increase in neutrophil levels is caused by short-term stress or increased physical activity, then no specific correction is required.
For persistent neutrophilia, depending on the disease that caused it, the following treatment methods are used:
- antimicrobial therapy - antibiotics are used for infections (amoxicillin, cefixime);
- antiplatelet therapy - in case of heart attack and a tendency to blood clots, acetylsalicylic acid and alteplase are prescribed;
- anti-inflammatory therapy - glucocorticosteroids (prednisolone) are used to reduce inflammation that provokes neutrophilia;
- chemotherapy – aimed at combating malignant tumors (cytostatics, antimetabolites).
If there is a local focus of inflammation, surgical treatment can be used. For example, it is relevant for appendicitis or abscesses. The menu should limit the amount of meat products, canned and smoked. The diet should be rich in vegetables and fruits.
To normalize the level of neutrophils in the blood, it is recommended to eat more vegetables and fruits. Photo: sommail / freepik.com
How to decipher the leukocyte formula?
Leukocyte formula, microscopy of leukocytes, five fractions of leukocytes, differentiation of leukocytes - in doctor’s prescriptions you can find many names for the same thing. Where can I find it and how to decrypt it?
What are leukocytes?
Leukocytes (white blood cells) are a large group of blood cells. Their main purpose is to protect the body from infections. All leukocytes are part of the immune system; they are involved in allergic, autoimmune, and tumor processes. Each type of white blood cell has its own role and is important for the body.
A general blood test without a leukocyte formula speaks only about the total content of leukocytes and does not reveal what type of leukocytes is responsible for the increase (leukocytosis) or decrease (leukopenia) of white blood cells. The leukocyte formula determines five types of leukocytes and is assessed in a comprehensive general blood test. To decipher the leukocyte formula, you need to evaluate the content of each type of leukocyte and their ratio to each other.
The leukocyte formula is calculated by an automatic blood analyzer. Taking the content of all white blood cells as 100%, it gives the percentage (%) of each type of white blood cell. It also automatically measures their content in blood volume (per liter). Sometimes a “hand count” and visual assessment of the blood smear under a microscope is required. For example, when the white blood cell count is altered, there are strange or immature cells, there are signs of anemia or a decrease in platelets in the general blood test. In this case, you can only see the percentage of the leukocyte formula.
Granulocytes - shock forces
The largest part of leukocytes is represented by granulocyte cells. They got their name due to the presence of inclusions (granules). The granules contain immune chemicals. In the leukocyte formula you can see three types of granulocytes: neutrophils, eosinophils, basophils. They differ in the structural features of the core and the coloring of the granules with different dyes. Granulocytes are important in the development of inflammation and immune defense of the body. They are capable of absorbing and digesting proteins and chemicals. All granulocytes mature in the bone marrow, maintaining a supply of mature cells there for 3-4 days. Granulocytes circulate in the blood for no more than 6 hours, moving into the tissues where they perform their function.
Neutrophils make up the largest number of leukocytes circulating in the blood. Every day, 1010 neutrophils enter the bloodstream. Neutrophilia (an increase in the number of neutrophils in the blood) is an indicator of a bacterial infection. The more severe the infection, the more neutrophils come out to fight. Due to their low life expectancy (about 4 days), younger, immature forms of cells (band cells, metamyelocytes, and others) begin to enter the blood. Doctors call this a “leukocyte shift to the left.” When there are very few neutrophils in the blood (neutropenia), the body is not protected from infections.
Eosinophils in the blood make up no more than 5% of the total number of leukocytes. Their concentration fluctuates throughout the day due to the influence of adrenal hormones. In the morning it is maximum. They accumulate in the submucosal layer of the gastrointestinal tract. Eosinophilia (increased eosinophilia in the blood) occurs with parasitic infections, allergic and autoimmune processes.
Basophils make up the smallest number of leukocytes in the blood (less than 1%) and are involved in allergic reactions by releasing histamine. This substance is responsible for bronchospasm, itching, swelling, and redness. Depending on where the basophils get to, there will be manifestations of allergic reactions: an attack of bronchial asthma, skin rash, urticaria, Quincke's edema (swelling of the larynx).
Monocytes are tissue hunters
The second link of leukocytes is monocytes. In the bone marrow, having formed in 5 days, they do not form a reserve. In the blood, monocytes make up about 10% of the mass of leukocytes, quickly disappearing into the tissues. Tissue macrophages, and this is what monocytes will be called, are mainly found in the liver, spleen, and lungs. Their life expectancy is very long (60 days). They are the main hunters of the immune system, because... absorb and process thousands of foreign proteins, turning them into antigens accessible to immune cells.
Monocytosis (an increase in monocytes in the blood) is associated with chronic infections, as well as with infections whose pathogens are hidden in the body’s cells (viruses, chlamydia, mycoplasma).
Lymphocytes are reliable defenders
Antigens processed by monocytes-macrophages and other immune cells attract lymphocytes. Lymphocytes provide acquired immunity by producing antibodies and memory cells to protect against re-infection.
Lymphocytes are formed in the bone marrow and circulate both in the blood and in the lymphatic system. Important organs of cell maturation are the thymus (thymus gland) and lymph nodes. Lymphocytes perform various immune functions, representing the second largest group of leukocytes. There is a special blood test (immunophenotyping) that allows you to identify different types of lymphocytes. This can be important for diseases of the immune system, HIV infection, etc.
In the leukocyte formula, both an increase in lymphocytes (lymphocytosis) - more typical for viral infections - and lymphopenia (a decrease in their number) are important. A lack of lymphocytes reduces the body's defenses and is observed in immunodeficiencies (including HIV infection).
In the Lab4U laboratory you can take the following tests with a 50% discount:
- General blood test with leukocyte formula (automatic counting)
- General blood test with microscopy (manual leukocyte count)
How to increase the number of neutrophils in the blood
To correct neutropenia, it is necessary to identify its cause. If a decrease in neutrophil levels is caused by taking medications, you should first weigh the possible risks of a decrease in neutrophil levels with the importance of the therapeutic effect of the drugs used. In extreme cases, the drug can be replaced with an analogue that does not affect the level of neutrophils in the blood. The underlying diseases that cause neutropenia are treated with antibiotics, anti-inflammatory and antiviral drugs.
It is recommended to consume the following products:
- any meat dishes (it is important that they are all well thermally processed);
- hard boiled eggs;
- pasteurized milk;
- cheese (except for varieties with mold);
- potato;
- rice;
- pasta;
- fruits and vegetables;
- alcohol only in consultation with a doctor.
Careful heat treatment of meat and eggs is necessary in order to exclude the possibility of bacteria and microbes entering the body, which actively multiply in poorly fried or undercooked protein dishes.
