Neutrophilia

 

 

Common causes include:

Infection ( Bacterial most common, but also viral- VZV, HSV, some fungal, parasitic)

Drugs especially Steroids

Inflammatory- RA, Gout, inflammatory bowel disease

Tissue damage, infarction

Hyposplenism/splenectomy

Smoking

Pregnancy

 

Primary haematological causes:

Myeloproliferative neoplasms

Chronic myeloid leukaemia

Acute myeloid leukaemia

Essential thrombocytosis

Polycythaemia vera

Primary myelofibrosis

 

A more extensive list can be found: https://bestpractice.bmj.com/topics/en-gb/1023

 

 

Management

Investigate and treat the underlying cause, if suspect primary haematological cause check splenomegaly

Investigations:

FBC/ Blood film

U&E, LFTs, CRP

 

Who to refer?

If acutely very unwell- consider admission under medical team

If new suspected acute leukaemia- admit under medical team following discussion with haematologist on call

If new suspected CML with WCC>100 X10⁹/L or symptoms of hyperviscosity- admit under medical team following discussion with haematologist on call

If neutrophilia with splenomegaly – refer haematology ( see link- splenomegaly)

If neutrophilia with other abnormality on blood film- Refer haematology

If persistent neutrophil count >15 X10⁹/L for > 4 weeks, with no obvious cause and no other sinister features- Refer to Haematology Advice & Guidance

 

 

References:

https://bestpractice.bmj.com/topics/en-gb/1023

www.gponline.com/causes-neutrophilia-treatment/haematology/haematology/article/668537

 

Contributors:

Dr Richard Noble, Consultant Haematologist, RCHT

Dr Bridgitte Wesson, GP & Kernow RMS Haematology guideline lead

 

Review date: 05/08/2020

Next Review 05/08/2021