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General Practice 2023

Lymphocytosis: what it can be and what to do

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Lymphocytosis: what it can be and what to do
Lymphocytosis: what it can be and what to do

Lymphocytosis is a condition that happens when the amount of lymphocytes, also called white blood cells, is above normal in the blood. The amount of lymphocytes in the blood is indicated in a specific part of the blood count, the leukogram, being considered lymphocytosis when more than 3900 lymphocytes are verified per mm³ of blood, which may vary according to the laboratory.

It is important to remember that this result is classified as an absolute count, because when the test result shows lymphocytes above 50%, it is called a relative count, and these values ​​may vary depending on the laboratory.

Lymphocytes are cells responsible for the body's defense, so when they are increased it usually means that the body is reacting to some microorganism, such as bacteria, viruses, but they can also be increased when there is a problem in the production of these cells.Learn more about lymphocytes.

Main causes of Lymphocytosis

Lymphocytosis is verified through the blood count, more specifically in the leukogram, which is the part of the blood count in which information related to white blood cells, which are the cells responsible for the body's defense, such as lymphocytes, leukocytes, monocytes, eosinophils and basophils.

The evaluation of the amount of circulating lymphocytes must be evaluated by the hematologist, general practitioner or by the physician who requested the exam. The increase in the number of lymphocytes can have several causes, the main ones being:

1. Mononucleosis

Mononucleosis, also known as kissing disease, is caused by the Epstein-Barr virus that is transmitted through saliva through kissing, but also through coughing, sneezing or sharing cutlery and cups. The main symptoms are red spots on the body, high fever, headache, swelling in the neck and armpits, sore throat, whitish plaques in the mouth and physical fatigue.

As lymphocytes act in the defense of the body, it is normal for them to be high, and it is also possible to verify other changes in the blood count, such as the presence of atypical lymphocytes and monocytes, in addition to changes in biochemical tests, especially C-Reactive Protein, to PCR.

What to do: Usually this disease is eliminated naturally by the action of the body's own defense cells, and can last from 4 to 6 weeks. However, the general practitioner may prescribe the use of some medications to relieve symptoms such as analgesics and antipyretics to reduce fever and anti-inflammatory drugs to reduce pain. Learn about treatment for mononucleosis.

2. Tuberculosis

Tuberculosis is a disease that affects the lungs, passes from person to person, and is caused by a bacterium known as Koch's bacillus (BK). Often the disease remains inactive, but when it is active it causes symptoms such as coughing up blood and phlegm, night sweats, fever, weight loss and loss of appetite.

In addition to high lymphocytes, the doctor may also check for an increase in monocytes, called monocytosis, in addition to an increase in neutrophils. If the person has symptoms of tuberculosis and suggestive changes in the blood count, the doctor may request a specific test for tuberculosis, called PPD, in which the person receives a small injection of the protein present in the bacteria that causes tuberculosis and the The result depends on the size of the skin reaction caused by this injection. Here's how to understand the PPD exam.

What to do: Treatment must be established by a pulmonologist or infectious disease specialist, and the person must be monitored regularly. The treatment for tuberculosis lasts about 6 months and is done with antibiotics that must be taken even if the symptoms disappear. Because even in the absence of symptoms, the bacteria can still be present and if treatment is interrupted, it can proliferate again and have consequences for the person.

The follow-up of the patient with tuberculosis should be done on a regular basis in order to check if there are still Koch's bacilli. samples.

3. Measles

Measles is an infectious disease caused by a virus that mainly affects children up to 1 year of age. This disease is considered highly contagious, as it can be easily transmitted from person to person through droplets released in coughing and sneezing. It is a disease that attacks the respiratory system, but can spread to the entire body causing symptoms such as red spots on the skin and throat, red eyes, cough and fever. Know how to recognize the symptoms of measles.

In addition to high lymphocytes, the general practitioner or pediatrician may check for other changes in the blood count and in immunological and biochemical tests, such as an increase in CRP, which indicates the occurrence of an infectious process.

What to do: You should consult your general practitioner or pediatrician as soon as symptoms appear, because even if there is no specific treatment for measles, the doctor will prescribe medication that relieve symptoms. Vaccination is the best way to prevent the emergence of measles and is indicated for children and adults and the vaccine is available free of charge at he alth posts.

4. Hepatitis

Hepatitis is an inflammation of the liver caused by different types of viruses or even caused by the use of certain medications, drugs or ingestion of toxins. The main symptoms of hepatitis are yellow skin and eyes, loss of weight and appetite, swelling on the right side of the belly, dark urine and fever. Hepatitis can be transmitted through sharing contaminated needles, unprotected sex, water and food contaminated with feces, and contact with blood from an infected person.

As hepatitis is caused by a virus, its presence in the body stimulates the functioning of the immune system, with an increase in the number of lymphocytes.In addition to changes in the leukogram and blood count, which usually indicate anemia, the doctor should also evaluate liver function through tests such as TGO, TGP and bilirubin, in addition to serological tests to identify the hepatitis virus.

What to do: Treatment for hepatitis is done according to the cause, however in case it is caused by a virus, it can be recommended by an infectious disease specialist, hepatologist or clinician general use of antivirals, rest and increased fluid intake. In the case of drug-induced hepatitis, the doctor should recommend replacing or suspending the drug responsible for liver damage. Know the treatment for each type of hepatitis.

5. Acute Lymphocytic Leukemia

Acute lymphocytic leukemia (ALL) is a type of cancer that arises in the bone marrow, which is the organ responsible for producing blood cells. This type of leukemia is called acute because the newly manufactured lymphocytes in the bone marrow are found circulating in the blood, without having undergone a maturation process, therefore being called immature lymphocytes.

As the circulating lymphocytes cannot perform their function correctly, there is a greater production of lymphocytes by the bone marrow in an attempt to compensate for this deficiency, which results in lymphocytosis, in addition to other changes in the blood count, such as thrombocytopenia, which is the decrease in the number of platelets.

It is the most common type of cancer in childhood, with many chances of cure, but it can also happen in adults. Symptoms of ALL are pale skin, nose bleeds, bruises on the arms, legs and eyes, swollen neck, groin and armpits, bone pain, fever, shortness of breath and weakness.

What to do: It is important to look for a pediatrician or general practitioner as soon as the first signs and symptoms of leukemia appear, so that the person can be immediately referred to the hematologist for that more specific tests are performed and the diagnosis can be confirmed. Most of the time, the treatment for ALL is done with chemotherapy and radiotherapy and, in some cases, a bone marrow transplant is recommended.See how bone marrow transplantation is performed.

6. Chronic Lymphocytic Leukemia

Chronic lymphocytic leukemia (CLL) is a type of malignancy, or cancer, that develops in the bone marrow. It is called chronic because both mature and immature lymphocytes can be observed circulating in the blood. This disease usually develops slowly, with symptoms being more difficult to notice.

Often CLL causes no symptoms, but they can appear in some cases, such as swelling in the armpits, groin or neck, night sweats, pain on the left side of the belly caused by an enlarged spleen and fever. It is a disease that mainly affects the elderly and women over 70 years of age.

What to do: An evaluation by a general practitioner is essential and in cases where the disease is confirmed, referral to a hematologist is necessary. The hematologist will confirm the disease through other tests, including a bone marrow biopsy.In the case of CLL confirmation, the doctor indicates the beginning of treatment, which generally consists of chemotherapy and bone marrow transplantation.

7. Lymphoma

Lymphoma is also a type of cancer that arises from diseased lymphocytes and can affect any part of the lymphatic system, but usually affects the spleen, thymus, tonsils and tongues. There are more than 40 types of lymphomas, but the most common are Hodgkin's and non-Hodgkin's lymphoma, and the symptoms are very similar to each other, such as lumps in the neck, groin, collarbone, belly and armpit, in addition to fever, sweating night, weight loss for no apparent reason, shortness of breath and cough.

What to do: With the onset of symptoms, it is recommended to look for a general practitioner who will refer you to an oncologist or hematologist who will order other tests, in addition to the blood count, to confirm the illness. Treatment will only be indicated after the doctor defines the degree of the disease, but chemotherapy, radiotherapy and bone marrow transplantation are usually performed.

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