Leucocytosis
A high white cell count by cell line: reactive neutrophilia versus CML, lymphocytosis and flow cytometry, monocytosis, eosinophilia with Strongyloides and PDGFRA, leucoerythroblastic films, spurious counts and the urgent problem of hyperleucocytosis.
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Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Leucocytosis is a white cell count above 11 x 10^9/L in adults. Always ask which cell line is high. The differential is more useful than the total.
- Most leucocytosis is reactive neutrophilia: infection, inflammation, steroids, smoking, stress.
- The film separates reactive from malignant. Look for blasts, basophilia, a myelocyte peak, smear cells, atypical lymphocytes and toxic granulation.
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Sources
- The 5th edition of the World Health Organization Classification of Haematolymphoid Tumours: Myeloid and Histiocytic/Dendritic NeoplasmsKhoury JD et al., Leukemia 2022;36:1703-19, 2022
- Guideline for the investigation and management of eosinophiliaButt NM et al., British Society for Haematology, Br J Haematol 2017;176:553-72, 2017
- World Health Organization-defined eosinophilic disorders: 2022 update on diagnosis, risk stratification, and managementShomali W, Gotlib J, Am J Hematol 2022;97:129-48, 2022
- Therapeutic Guidelines, Antibiotic (strongyloidiasis)AU/NZTherapeutic Guidelines Limited
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy