Lymphocytosis
Template:Short description Template:Infobox medical condition (new) Lymphocytosis is an increase in the number or proportion of lymphocytes in the blood. Absolute lymphocytosis is the condition where there is an increase in the lymphocyte count beyond the normal range while relative lymphocytosis refers to the condition where the proportion of lymphocytes relative to white blood cell count is above the normal range. In adults, absolute lymphocytosis is present when the lymphocyte count is greater than 5000 per microliter (5.0 billion/L), in older children greater than 7000 per microliter and in infants greater than 9000 per microliter.<ref>Miale, John B. Laboratory Medicine: hematology. 5th. St. Louis: C.V. Mosby, 1977.</ref> Lymphocytes normally represent 20% to 40% of circulating white blood cells. When the percentage of lymphocytes exceeds 40%, it is recognized as relative lymphocytosis.
Causes
Lymphocytosis is a feature of infection, particularly in children. In the elderly, lymphoproliferative disorders, including chronic lymphocytic leukemia and lymphomas, often present with lymphadenopathy and a lymphocytosis.Template:Cn
Causes of absolute lymphocytosis include:
- acute viral infections, such as infectious mononucleosis<ref name=Kumar12-6/> (glandular fever), hepatitis<ref name=Kumar12-6>Table 12-6 in: Template:Cite book 8th edition.</ref> and cytomegalovirus infection<ref name=Kumar12-6/>
- other acute infections such as pertussis<ref name=Kumar12-6/>
- some protozoal infections, such as toxoplasmosis and American trypanosomiasis (Chagas disease)
- chronic intracellular bacterial infections such as tuberculosis<ref name=Kumar12-6/> or brucellosis<ref name=Kumar12-6/>
- chronic lymphocytic leukemia<ref>Template:Cite web</ref>
- acute lymphoblastic leukemia<ref>Template:Cite web</ref>
- lymphoma<ref>Template:Cite web</ref><ref>Template:Cite web</ref>
- post-splenectomy state<ref>Template:Cite journal</ref>
- CARD11-related congenital B cell lymphocytosis (rare, also known as BENTA disease)<ref>Template:Cite journal</ref>
Causes of relative lymphocytosis include:
- age less than 2 years;
- acute viral infections;
- connective tissue diseases,<ref>William C. Shiel Jr.,Connective Tissue Disease</ref>
- thyrotoxicosis,<ref>Template:Cite web</ref>
- Addison's disease,<ref>Template:Cite web</ref>
- splenomegaly with splenic sequestration of granulocytes.<ref>Template:Cite web</ref>
Diagnosis
Lymphocytosis is usually detected when a complete blood count is obtained. If not provided the lymphocyte count can be calculated by multiplying the total white blood cell (WBC) count by the percentage of lymphocytes found in the differential count.<ref>For example, if the total WBC count is 30,000, and the %lymphocytes is 30, the absolute lymphocyte count is 9,000 per microliter.</ref> The lymphocyte count can also be directly measured by flow cytometry.Template:Cn