LEUCOCITOSIS CON NEUTROFILIA: MÁS ALLÁ DE LA INFECCIÓN

Autores/as

  • Fabricio Andrés Lasso Andrade Universidad del Cauca
  • Diego Fernando Dorado Universidad del Cauca
  • Tomás Omar Zamora Universidad del Cauca

Resumen

El hallazgo de leucocitosis con neutrofilia se ha asociado clásicamente a un origen infeccioso, aunque existen muchas otras condiciones benignas o malignas que pueden producir este hallazgo en el hemograma. Se deben tener en cuenta las causas de pseudoleucocitosis como el agrupamiento de plaquetas por el anticoagulante ácido dietilenediaminotetraacético (EDTA) que se presenta también como una causa de pseutrombocitopenia, además de la pseudoleucocitosis que se presenta en las crioglobulinemias. Existen causas primarias como la neutrofilia hereditaria crónica, trastorno genético que se caracteriza por tener activado el gen del CSF3 (factor estimulante de colonias de granulocitos) produciendo proliferación de neutrófilos, así también en los neonatos con síndrome de Down se presenta un recuento aumentado de leucocitos como parte del Trastorno mieloproliferatio transitorio, que en la mayoría de veces es autolimitado. La leucocitosis con neutrofilia se presenta como un desafío para el médico, dando la imperiosa necesidad de una búsqueda meticulosa de sus causas reales, las cuales pueden ser espurias, primarias o secundarias; el clínico debe basar su aproximación diagnóstica en una adecuada historia clínica y un acucioso examen físico. En ese contexto, la presente revisión narrativa persigue como objetivo dar a conocer las diferentes causas de la leucocitosis con neutrofilia tendiente a describir una aproximación clínica para su abordaje diagnóstico.

Biografía del autor/a

Fabricio Andrés Lasso Andrade, Universidad del Cauca

MD. Universidad del Cauca, Facultad Ciencias de la Salud. Popayán, Colombia.

Diego Fernando Dorado, Universidad del Cauca

MD. Universidad del Cauca, Facultad Ciencias de la Salud. Popayán, Colombia.

Tomás Omar Zamora, Universidad del Cauca

MD. MSP. Universidad del Cauca, Facultad de Ciencias de la Salud. Popayán, Colombia.

Referencias bibliográficas

1. Mónica Torrens P. Interpretación Clínica Del Hemograma. Rev. Med. Clin. Condes. 2015; 26 (6): 713-725.
2. Germán Campuzano Maya. Del hemograma manual al hemograma de cuarta generación. Medicina & Laboratorio. 2007; 13: 11-12.
3. Thomas D Coates. Approach to the patient with neutrophilia – UpToDate. Post TW (Ed), UpToDate, Waltham, MA. (Acceso en Marzo 04/2017).
4. Gordan HG, Larson NL. Use of sequestrene as an anticoagulant. Am J Clin Pathol. 1955; 23: 613-18.
5. Berkman N, Michaeli Y, Or R, Eldor A. EDTA-dependent pseudothrombocytopenia: A clinical study of 1 8 patients and a review of the literature. Am J Hematol. 1991; 36: 195.
6. Solanki DL, Blackburn BC. Spurious leukocytosis and thrombocytopenia. A dual phenomenon caused by clumping of platelets in vitro. JAMA. 1983; 250: 2514.
7. Savage RA. Pseudoleukocytosis due to EDTA-induced platelet clumping. Am J Clin Pathol. 1984; 81: 317.
8. Bizarro N. EDTA-dependent pseudothrombocytopenia: a clinical and epidemiological study of 112 cases, with 10-year follow-up. Am J Hematol. 1995; 50: 103-109.
9. Carvajal-Vega, Edgar; Padilla-Cuadra, Juan I.; LópezVillegas, Jorge; Mata-Sánchez, María del Milagro. Pseudotrombocitopenia por EDTA en paciente con polineuropatía desmielinizante inflamatoria crónica. Acta Méd Costa. 2016; 58 (2): 84-87.
10. Winfield JB. Cryoglobulinemia. Hum. Pathol. 1983; 14: 350-354.
11. Yadav YK, Aggarwal R, Gupta O, S. Ranga hepatitis-B crioglobulinemia asociada se presenta como pseudoleucocytosis. J Lab Physicians. 2011; 3: 133-5.
12. Patel KJ, Hughes CG, Parapia LA. Pseudoleucocytosis and pseudothrombocytosis due to cryoglobulinaemia. J Clin Pathol. 1987; 40: 120.
13. Plo I et al. An activating mutation in the CSF3R gene induces a hereditary chronic neutrophilia. J Exp Med. 2009; 206 (8): 1701. Epub 2009 Jul 20.
14. Zipursky A. Transient leukemia—a benign form of leukaemia in newborn infants with trisomy 21. Br J Haematol. 2003; 120: 930-938.
15. Gosavi AV, Murarkar PS, Lanjewar DN, Ravikar RV. Tranisent leukemia in Down syndrome: report of two cases with review of literature. Indian J Hematol Blood Transfus. 2011; 27: 172-176.
16. M Madkaikar, Z Currimbhoy, M Gupta, M Desai and M Rao. Clinical Profile of Leukocyte Adhesion Deficiency Type I. Indian Pedia. January 16, 2012; 49.
17. Etzioni A. Leukocyte Adhesion Deficiency (LAD) Syndromes. Orphanet Encyclopedia, July 2005.
18. Wendy S, Hoffman R. White blood cells 1: non-malignant disorders. Lancet. Apr 15, 2000; 355 (9212): 13517.
19. Widick, MD, Eric S. Winer, MD Leukocytosis and Leukemia. Prim Care Clin Office Pract. 2016; 43: 575–587.
20. Pedersen B K, Rohdeand K., Ostrows KI.Recovery of the immune system after exercise. s.l.: Ac Phy Scand. 1998; 162: 325-332.
21. Timo Heidt et al. Chronic variable stress activates hematopoietic stem cells. Nat Med. 2014; 20: 754–758.
22. Que Deng et al. Psychological stress promotes neutrophil infiltration in colon tissue through adrenergic signaling in DSS-induced colitis model. Brain Beha Immu, 2016, Vol. 57 243-254.
23. John Q, William l. The Effects of Acute Exercise on Neutrophils and Plasma Oxidative Stress. Off J Ameri College of Sp Med. 2003; Vol. Medicine & science in sports & exercise.
24. D. C. Nieman, et all. Effects of Long-Endurance Running on Immune System Parameters and Lymphocyte Function in Experienced Marathoners. Int J Sports Med. 1989; 10: 317-323.
25. Furze Rebecca C., Rankin S. Neutrophil mobilization and clearance in the bone marrow. Black Publi, Immu. 2008; 125: 281-288.
26. Colotta F. et al. Modulation of granulocyte survival and programmed cell death by cytokines and bacterial products. Blood. 1992; 80: 2012-2020.
27. Layla A. Al-Gwaiz, Hanan H. Babay. The Diagnostic Value of Absolute Neutrophil Count, Band Count and Morphologic Changes of Neutrophils in Predicting Bacterial Infections. Med Princ Pract. 2007; 16: 344–347.
28. CoxG. Glucocorticoid treatment inhibits apoptosis in human neutrophils. J Immunol. May 1, 1995; 154 (9): 4719-25.
29. Liles WC, Huang JE, Llwellyn C, Sengupta D, Price TH, Dale DC. A comparative trial of granulocyte-colony-stimulating factor and dexamethasone, separately and in combination, for the mobilization of neutrophils in the peripheral blood of normal volunteers. Transfusion. 1997; 37: 182–187.
30. Dale DC, Fauci AS, Guerry DI, et al. Comparison of agents producing a neutrophilic leukocytosis in man. Hydrocortisone, prednisone, endotoxin, and etiocholanolone. J Clin Invest. 1975; 56 (4): 808–13.
31. Kast RE, 2008, Burlington, VT, USA. How lithium treatment generates neutrophilia by enhancing phosphorylation of GSK-3, increasing HIF-1 levels and how this path is important during engraftment. B Marrow Trans. 2008; 41: 23–26.
32. Focosi D. Azzara A. Kast RE. Carulli G. Petrini M. Lithium and hematology: established and proposed uses. J of Leu Biol. January, 2009; 85.
33. Zhang S, Condac E, Qiu H, Jiang J, Gutierrez-Sanchez G, Bergmann C, Handel T, Wang L. Heparin-induced Leukocytosis Requires 6-O-Sulfation and Is Caused by Blockade of Selectin- and CXCL12 Protein-mediated Leukocyte Trafficking in Mice. J Biol Chem. Feb 17, 2012; 287(8): 5542–5553.
34. Benschopa RJ.Rodriguez-Feuerhahnb M. Schedlowskib M. Catecholamine-Induced Leukocytosis: Early Observations, Current Research, and Future Directions. Brain Behav Immun. Jun, 1996; 10 (2): 77-91.
35. Tatsushi Suwa, James C. Hogg, Dean English, Stephan F. Van Eeden Interleukin-6 induces demargination of intravascular neutrophils and shortens their transit in marrow. Am J Physiol Heart Circ Physiol. 2000; 279 (6): H2954-H2960.
36. Welte, K., & Boxer, L. A. Severe chronic neutropenia: Patho and therapy Seminars Hemato. 1997; 34 (4): 267278.
37. Bonilla M. A. et al Long-term safety of treatment with recombinant human granulocyte colony-stimulating factor (r-metHuG-CSF) in patients with severe congenital neutropenias. Brit J of Haema. 1994; 88: 723–730.
38. Richards JR, Farias VF, Clingan CS. Association of leukocytosis with amphetamine and cocaine use. S World J. 2014; 207651.
39. Flodd RG, Chiang VW. Rate and prediction of infection in children with diabetic ketoacidosis.Am J Emerg Med. Jul, 2001; 19 (4): 270-3.
40. Wei Xu, Hai-feng Wu, Shao-gang Ma, Feng Bai, Wen Hu, Yue Jin, Hong Liu. Correlation between Peripheral Blood Cell Counts and Hyperglycemic Emergencies. Int. J. Med. Sci. 2013; 10.
41. Stentz FB, Umpierrez GE, Cuervo R, Kitabchi AE. Proinflammatory cytokines, markers of cardiovascular risks, oxidative stress, and lipid peroxidation in patients with hyperglycemic crises. Diabetes. 2004; 53 (8): 2079.
42. Obi N, Katabami T, Asai S, Saito N, Tanaka Y. Fulminant type 1 diabetes complicated by leukemoid reaction. Intern Med. 2008; 47 (9): 847-51.
43. Burris AS. Leukemoid reaction associated with severe diabetic ketoacidosis. South Med J. May, 1986; 79 (5): 647-8.
44. Slovis CM, Mork VG, Slovis RJ, Bain RP. Diabetic ketoacidosis and infection: leukocyte count and differential as early predictors of serious infection. Am J Emerg Med. 1987; 5 (1): 1.
45. Alzamani Mohammad Idrose. Acute and emergency care for thyrotoxicosis and thyroid storm. Acu Med & Surg. 2015; 2: 147–157.
46. Pouchot J, Sampalis JS, Beaudet F, Carette S, Décary F, Salusinsky-Sternbach M et al. Adult Still’s disease: manifestations, disease course and outcome in 62 patients. Medicine (Baltimore). Mar, 1991; 70 (2): 118-36.
47. Alejandro Olivéa, Susana Holgadoa, Marta Vallsb. Enfermedad de Still del adulto. Rev Esp Reumatol. 2001; 28: 32-7.
48. Ginartea M, Toribioa J. Síndrome de Sweet. Med Clin. 2009; 133: 31-5.
49. Von den Driesch P. Sweet’s syndrome (acute febrile neutrophilic dermatosis). J Am Acad Dermatol. 1994; 31(4): 535.
50. Dong Soo Kim. Kawasaki Disease. Yon Medi J. 2006; 47 (6): 759 – 772.
51. Bayers, Stephanie et al. Kawasaki disease. J American A of Derma. 69 (4): 501.e1-501.e11.
52. Xu, Ruonan et al. “The Role of Neutrophils in the Development of Liver Diseases.” Cell and Mole Immuno. 2014; 11 (3): 224–231
53. Kaplan MJ. Role of neutrophils in systemic autoimmune diseases. Arthri, Res & Ther. 2013; 15: 219.
54. Smith CK; Kaplan MJ. The role of neutrophils in the pathogenesis of systemic lupus erythematosus. Curr Opin Rheuma. 2015; 27 (5): 448–453.
55. Spencer RP, Grimmond AP, Treschuk-Bahn J. Abdominal trauma with leukocytosis and Howell-Jolly bodies. Idiopathic functional asplenia. Clini Nucl Med. 1988; 13: 544.
56. Joyce RA, O’Donnell J, Sanghvi J, Westerman MP. Asplenia and abnormal neutrophil kinetics in chronic idiopathic neutrophilia. Am J Med. 1980; 69: 633–6.
57. Lipson RL, Bayrd ED, Watkins CH. The post-splenectomy blood picture. Am J Clin Pathol. 1959; 32: 526–32.
58. McBride JA, Dacie JV, Sharpley R. The effect of splenectomy on the leukocyte count. Br J Haematol. 1968; 14: 225–31.
59. Millard RE, Banerjee DK. Changes in T and B blood lymphocytes after splenectomy. J Clin Pathol. 1979; 32: 1045–9.
60. Konstantinos G. Toutouzas et al. Leukocytosis After Posttraumatic Splenectomy. A Physiologic Event or Sign of Sepsis? Arch Surg. 2002; 137 (8): 924-929.
61. Qiu MZ et al. Incidence of anemia, leukocytosis, and thrombocytosis in patients with solid tumors in China. Tumour Biol. Dec, 2010; 31 (6): 633-41.
62. Savage DJ Szydlo RM Chase Aet al. Clinical features at diagnosis in 430 patients with chronic myeloid leukaemia seen at a referral centre over a 16-year period. Br J Haematol. 1997; 96: 111–116.
63. Millot F Traore P Guilhot Jet al. Clinical and biological features at diagnosis in 40 children with chronic myeloid leukemia. Pediatrics. 2005; 116: 140–143.
64. Rowe JM Lichtman MA. Hyperleukocytosis and leukostasis: common features of childhood chronic myelogenous leukemia. Blood. 1984; 63: 1230–1234.
65. Stemmelin GR, Doti CA, Shanley CM, et al. Smoking as a cause for mild chronic neutrophilia. Blood. 2004; 104: 3796.
66. Besime Inal, Tuba Hacıbekiroglu, Bilger Cavus, Zeliha Musaoglu, Hatice Demir, and Berrin Karadag. Effects of smoking on healthy young men’s hematologic parameters. North Clin Istanb. 2014; 1 (1): 19–25.
67. Kawada T. Smoking-induced leukocytosis can persist after cessation of smoking. Arch Med Res. 2004; 35: 246.
68. Van Tiel E, Peeters PH, Smit HA, et al. Quitting smoking may restore hematological characteristics within five years. Ann Epidemiol. 2002; 12 (6): 378–88.
69. Weir AB, Lewis Jr JB, Arteta-Bulos R. Chronic Idiopathic Neutrophilia: Experience and Recommendations. South Med Journal. 2011; 104: 499-504.
70. Herishanu, Y., Rogowski, O., Polliack, A. and Marilus, R. Leukocytosis in obese individuals: possible link in patients with unexplained persistent neutrophilia. Euro J Haemato. 2006; 76: 516–520.

Cómo citar

[1]
Lasso Andrade, F.A. et al. 2018. LEUCOCITOSIS CON NEUTROFILIA: MÁS ALLÁ DE LA INFECCIÓN. Medicina. 40, 3 (oct. 2018), 323–331.

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Publicado

2018-10-07

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Artículos de Revisión