What to know about high white blood cell count?

Overview 

White blood cells, known as leukocytes, are essential in maintaining the body’s overall well-being. Their primary function is safeguarding the body against foreign substances and combat infections. White blood cells are crucial in combating infections and maintaining overall health. 

Fluctuations in white blood cell levels can occur in various situations, such as during infections, pregnancy, and certain types of cancers. 

A high white blood cell count can indicate that the immune system works to eliminate an infection. Additionally, it may serve as an indication of physical or emotional stress. Individuals with specific blood cancers may also exhibit high levels of white blood cells. 

A low white blood cell count can signify that an injury or condition is destroying cells faster than the body can produce them or that the body is generating an insufficient amount. 

White blood cells constitute approximately 1% of all blood cells and are vital for the proper functioning of the immune system. They are also referred to as leukocytes. 

The bone marrow continuously generates white blood cells, which are then stored within the blood and lymphatic systems until they are required to combat an infection or disease within the body. 

High white blood cell count 

It is called leukocytosis when the number of white blood cells exceeds the normal range. While an increase in leukocytes is typically observed when actively performing their duties, certain conditions can also lead to this elevation. 

It is important to note that the definition of a normal white blood count varies among individuals. For adults, an average count ranges from 4,500 to 11,000 per microliter. However, newborns have significantly higher counts, reaching levels as high as 38,000.  

As the child grows, this count gradually decreases and eventually reaches the levels observed in adults. Additionally, pregnant women tend to have slightly elevated white blood cell counts. 

WBCs or Leukocytes, despite their significance, constitute merely approximately 1% of the blood composition. Similar to other blood cells, they are produced within the bone marrow. Continuously generated leukocytes have a brief lifespan, with specific cells surviving for less than a day.  

Types of high white blood cells or leukocytosis 

Lymphocytes: Lymphocytes play a crucial role in producing antibodies, aiding the body’s defence against bacteria, viruses, and other potential threats. 

Neutrophils: Neutrophils, on the other hand, are highly potent white blood cells that effectively eliminate bacteria and fungi.  

Basophils: Basophils serve as an alarm system for the body, releasing chemicals into the bloodstream to combat allergies and notify the presence of infections.  

Eosinophils: Eosinophils, meanwhile, are tasked with the destruction of parasites and cancer cells, and they also contribute to allergic responses.  

Monocytes: Monocytes are responsible for attacking and breaking down germs and bacteria that infiltrate the body. In some instances, monocytes migrate to various organs, transforming into macrophages. Macrophages are multifunctional cells that carry out multiple tasks, such as removing dead or damaged tissue, destroying cancer cells, and regulating the immune response. 

Various health conditions are associated with each form of leukocytosis, such as inflammation and infections for neutrophilia, leukaemia and viral infections for lymphocytosis, cancer and other types of infections for monocytosis, parasites and allergies for eosinophilia, and leukaemia for basophilia. 

Causes of high white blood cells 

• Infection 
• Medications, such as corticosteroids 
• Immunosuppression 
• A bone marrow or immune disorder 
• Emotional stress or trauma 
• Inflammation 
• Smoking 
• Excessive exercise 
• Labor 
• Genetic or hereditary conditions 
• Pregnancy 
• Obesity 
• Allergic reactions 

The elevation of white blood cell levels can be attributed to specific respiratory ailments like tuberculosis or whooping cough. While some individuals may experience an impact on all white blood cells, others 

may only have a particular type affected due to a specific disease. If there is an increase in the levels of a specific type of white blood cell, it could be due to a particular trigger. 

Elevated monocyte levels may indicate chronic infection, autoimmune or blood disorders, cancer, or other medical conditions.  

Lymphocytic leukocytosis, characterised by an increase in lymphocytes, may be caused by a virus, infection, or specific lymphomas and types of leukaemia.  

Neutrophilic leukocytosis, a normal immune response to infection, injury, inflammation, certain medications, and certain types of leukaemia, is characterised by increased levels of neutrophils. 

Basophil levels may rise in people with hypothyroidism, allergies, or leukaemia. High levels of eosinophils may indicate a parasitic infection, medication, allergen, or asthma.  

In some cases, there may be no identifiable cause for an increase in white blood cells, known as idiopathic hypereosinophilic syndrome, which can lead to severe complications. 

Symptoms of high white blood cells 

In cases where there is an excessive amount of white blood cells in the body, it can result in the thickening of the blood, leading to a condition known as hyperviscosity syndrome. While this condition is uncommon, it can occur in individuals with leukaemia. Hyperviscosity syndrome can cause a range of serious issues, such as:

• Stroke 
• Vision problems 
• Difficulty breathing 
• Bleeding from the intestines, mouth, or stomach

Additionally, leukocytosis may cause other symptoms, which may be linked to the specific type of elevated white blood cell or any underlying health conditions that contribute to leukocytosis. 

Some other common symptoms of high white blood cells include:

• Fever 
• Night sweats 
• Wheezing 
• Easy bruising 
• Pain 
• Difficulty breathing 
• Weight loss 
• Hives and itching 

High white blood cells during pregnancy 

During pregnancy, it is common for individuals to experience elevated levels of white blood cells, which tend to rise gradually. In the final trimester, the WBC count typically ranges from 5,800 to 13,200 per microliter of blood. 

Furthermore, the labour and delivery process can induce stress, leading to an additional increase in white blood cell levels. Even after childbirth, the WBC count remains slightly higher than normal, usually measuring around 12,700 per microliter of blood. 

Diagnosis of high white blood cells 

Typically, healthy adults who are not pregnant have white blood cell levels ranging from 4,500 to 11,000 per microliter of blood. Exceeding this range may indicate leukocytosis. If your WBC counts fall between 50,000 and 100,000 per microliter of blood, it could signify a severe infection, organ rejection, or a solid tumour. Extremely high WBC counts over 100,000 are usually associated with leukaemia or other blood and bone marrow cancers. Three tests are commonly employed to identify the reason behind elevated white blood cell levels. 

Complete blood count (CBC) with differential: The Complete blood count (CBC) with differential is a commonly performed test when the white blood cell (WBC) count exceeds the normal range. This test uses a machine to analyse the percentage of each type of WBC present in a blood sample. 

Peripheral blood smear: In cases of neutrophilia or lymphocytosis, the doctor may opt for a Peripheral blood smear. This test evaluates the form and maturity of all blood cells. It may or may not confirm the type of leukocytosis, and if immature WBCs are detected, it may necessitate a bone marrow biopsy. The process involves applying a thin layer of blood onto a glass slide and examining the cells under a microscope. 

Bone marrow biopsy: A Bone marrow biopsy is conducted to differentiate between leukaemia and benign causes. This test entails extracting a sample of bone marrow, the tissue responsible for WBC 

production, from the centre of a bone using a needle. The sample is examined under a microscope to identify abnormal cells or issues with WBC production in the bone marrow. 

Treatment for high white blood cells  

The approach to managing leukocytosis is contingent upon its underlying cause. If a bacterial infection is responsible for the elevated white blood cell count, antibiotics will be recommended by your healthcare provider. Conversely, antihistamines are likely necessary if leukocytosis is linked to an allergic reaction. Additionally, there are other conventional treatments available for addressing a heightened white blood cell count, such as:

• Anti-inflammatory medications
• Treating asthma through inhalers 
• Improving blood flow through IV fluids 
• Quickly reducing the WBC count through the Leukapheresis procedure 
• Cancer treatments such as chemotherapy, radiation therapy, or stem cell transplants  
• Medications that reduce anxiety or stress  

Prevention of high white blood cells 

Leukocytosis, being a normal immune response, does not necessarily require prevention. In instances such as fighting off inflammation or infection, an increase in white blood cells is essential. However, some measures can be taken to maintain a healthy white blood cell count: 

1. Frequent handwashing to minimise the chances of infection. 
2. Steer clear of potential allergens. 
3. Refrain from smoking. 
4. Maintain good oral hygiene practices. 
5. Regularly visit your dentist every six months. 
6. Adhere to the prescribed medication regimen provided by your healthcare provider. 
7. Explore methods to reduce stress levels, such as mindfulness or meditation. 
8. Seek appropriate treatment for anxiety or depression when necessary.

Summary 

It is common for leukocytosis to occur as a natural immune response due to infection or inflammation. However, it can also be linked to stress, anxiety, or pregnancy. A heightened white blood cell count may indicate a more severe condition in certain instances. Therefore, it is essential to consult with a healthcare professional to identify the underlying cause of leukocytosis and determine if medical intervention is required. 

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