Leukocytosis left shift steroids

Approach to lymphocytosis: ALC>4000/uL
It's either reactive or clonal:
Reactive includes:
1) Infections:
- viral: HIV (in acute infection), EBV (mono), CMV, HHV6, HTLV-1
- bac: bordatella pertussis, bartonella (cat scratch disease)
- toxo, babesiosis (also causes hemolytic anemia)
2) Hypersensitivity reactions
- drugs, acute serum sickness
3) stress-induced (status epilepticus, trauma)
4) post splenectomy
5) polyclonal B cell lymphocytosis

Clonal :
1) ALL
2) CLL
3) LGL leukemia
4) thymoma

A "left shift" refers to the presence of increased proportions of younger, less well differentiated neutrophils and neutrophil-precursor cells in the blood. This generally reflects early or premature release of myeloid cells from the bone marrow , the site where neutrophils are generated. A severe neutrophilia with left shift is referred to as a leukemoid reaction . The leukocyte alkaline phosphatase (LAP) score, which refers to the amount of alkaline phosphatase per neutrophil, will increase. In a severe infection, toxic granulation changes happen to the neutrophils.

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Leukocytosis left shift steroids

leukocytosis left shift steroids

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