In a blood test what is wbc

White blood cells, also called leukocytes, fight infection. They move throughout your body in your blood, looking for invaders. And your body is continuously making a fresh supply.

Your doctor measures how many of these cells you have by sending some of your blood to a lab to do a complete blood count, or CBC. Your white blood cell count is one of the numbers you get back from this test. It may point toward or confirm a diagnosis, or show whether a treatment is working or not.

Most often, a low white blood cell count is nothing to worry about.

What Is "Low"?

How many white blood cells (WBCs) someone has varies, but the normal range is usually between 4,000 and 11,000 per microliter of blood.

A blood test that shows a WBC count of less than 4,000 per microliter (some labs say less than 4,500) could mean your body may not be able to fight infection the way it should. A low number is sometimes called leukopenia.

Causes

Your doctor will do a physical exam and consider symptoms that you have along with your past medical issues to figure out what's behind your result.

Bone marrow problems: The spongy center of your bones, which is called the bone marrow, makes blood cells. Low WBC counts are often linked to bone marrow problems. Being around certain chemicals, like benzene and pesticides, as well as some types of cancer and cancer treatments including chemotherapy and radiation, can hurt your bone marrow's ability to make WBCs.

Autoimmune disorders: Some autoimmune diseases, like lupus and rheumatoid arthritis, will tell your body to attack and destroy its own WBCs.

Infection: Viruses can affect your bone marrow and cause low WBCs for a while. Severe infections, like blood infections, can lead to your body using up WBCs faster than it can make them. HIV https://www.webmd.com/hiv-aids/understanding-aids-hiv-symptoms kills a specific kind of white blood cell.

Medicines: Some drugs, including antibiotics, can destroy WBCs.

Nutrition: Not eating well or low levels of certain vitamins, such as folic acid and B12, can affect how your body makes WBCs. Alcohol abuse can mess with the nutrients in your body and with WBC counts, too.

Spleen problems: The spleen also makes WBCs. Infections, blood clots, and other problems can make it swell and not work the way it should. This will drop your WBC count.

Follow-up Tests

If there's no clear reason for a low white blood cell count, your doctor will probably want to do the test again, or do a differential or "diff" along with the CBC.

This other test gives a lot more detail. There are normal ranges for each of the five kinds of WBCs, and some problems only affect one type. The results of a diff could help your doctor narrow down what's going on.

Many times, a repeated test will show that your WBC count is normal.

Your doctor may want to do more tests, based on the symptoms you have. For instance, you might get checked for strep throat or mono. Other blood tests can look for a viral infection, inflammation, or allergies. The doctor may want to take a sample of your bone marrow to see if it's healthy.

What Happens Next?

When your WBC count is very low, you may need to take steps to avoid an infection.

Your doctor may ask you to see a hematologist. This is a specialist who has extra training for diagnosing and treating blood count problems.

If your WBC count stays low or keeps getting lower, work with your doctor to find out why it's happening. The right treatment should help your white blood cell count return to normal.

Show Sources

SOURCES:

University of Rochester Medical Center: "What Are White Blood Cells?"

The Ohio State University Comprehensive Cancer Center: "Understanding Blood Cell Counts."

American Cancer Society: "Understanding Your Lab Test Results."

Leukemia & Lymphoma Society: "Understanding Blood Counts."

Mayo Clinic: "Low white blood cell count," "Neutropenia," "Enlarged spleen (splenomegaly)," "Bone marrow biopsy and aspiration."

LabTestsOnline.org: "White Blood Cell Count."

Scientific American: "Even at Low Levels, Benzene Takes Toll on White Blood Cells."

Journal of Occupational Medicine and Toxicology: "Pesticide exposure, risk factors and health problems among cutflower farmers: a cross sectional study."

Leukocytosis, or high white blood cell count, can indicate a range of conditions, including infections, inflammation, injury and immune system disorders. A complete blood count (CBC) is usually performed to check for leukocytosis. Treating the underlying condition usually reduces your white blood cell count.

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Overview

What is leukocytosis?

Leukocytosis means you have a high white blood cell count. This means you have more white blood cells than normal. Leukocytosis is a normal immune response and isn’t always a cause for concern. Most of the time, it means that your body is fighting off infection or inflammation. However, there are times when a high white blood cell count could indicate something more serious, such as leukemia.

Types of leukocytosis

There are five types of white blood cells (leukocytes), so there are five types of leukocytosis, depending on which type of cell is affected:

  • Neutrophilia leukocytosis is caused by a high number of neutrophils (the most plentiful type of white blood cell, which helps resolve infections and heal damaged tissues).
  • Lymphocytosis refers to high levels of lymphocytes (white blood cells that protect your lymphatic system).
  • Monocytosis is caused by a high number of monocytes (white blood cells that boost your immune responses).
  • Eosinophilia refers to high levels of eosinophils (white blood cells that play a role in fighting infections and inflammation). Eosinophilia is common and is often related to allergies, parasitic infections or autoimmune disorders.
  • Basophilia, the rarest form of leukocytosis, is characterized by an increased number of basophils (white blood cells that play a role in fighting parasitic infections, preventing blood clotting and responding to allergic reactions).

What does a high white blood cell count mean?

White blood cells are an important and necessary part of your immune system. Produced in your bone marrow, they defend your body against infections and disease. But, when there are too many white blood cells, it usually means you have infection or inflammation in your body. Less commonly, a high white blood cell count could indicate certain blood cancers or bone marrow disorders.

What is considered a high white blood cell count?

Typically, if there are more than 11,000 white blood cells in a microliter of your blood, it’s considered leukocytosis.

High white blood cell count during pregnancy

A high blood cell count during pregnancy is normal. Your body is simply experiencing the stress of carrying a baby. Your healthcare provider will run routine blood tests throughout your pregnancy to make sure nothing out of the ordinary is going on.

Is leukocytosis a blood cancer?

No. Leukocytosis refers to a high white blood cell count, which can occur for a number of reasons. Rarely, a high white blood cell count can be a symptom of certain blood cancers, such as acute myeloid leukemia, chronic myelogenous leukemia and chronic lymphocytic leukemia.

Symptoms and Causes

What are the signs and symptoms of leukocytosis?

Many leukocytosis symptoms could indicate an infection or something more serious, such as lymphoma or leukemia. Common warning signs include:

  • Fever.
  • Fatigue.
  • Pain.
  • Difficulty breathing.
  • Wheezing.
  • Night sweats.
  • Unexpected weight loss.
  • Rash.

Easy bruising may indicate thrombocytopenia (low platelet count) or severe acute leukemia. In cases of severe acute leukemia, extremely elevated white blood cells can thicken your blood and decrease blood flow. As a result, hyperviscosity syndrome can develop. This condition can cause serious health problems, such as stroke, internal bleeding or vision impairment.

What causes leukocytosis?

Leukocytosis is most commonly caused by infection or inflammation. Other high white blood cell count causes may include:

  • Excessive physical or emotional stress (such as fever, injury or surgery).
  • Burns.
  • Immune system disorders such as lupus or rheumatoid arthritis.
  • Thyroid problems.
  • Dental caries (cavities).
  • Certain medicines, including lithium, corticosteroids and beta-agonists.
  • Allergies.
  • Splenectomy (removal of your spleen).
  • Smoking.
  • Obesity.

Less commonly, leukocytosis is associated with:

  • Leukemia.
  • Lymphoma.
  • Bone marrow disorders such as polycythemia vera or myelofibrosis.

Diagnosis and Tests

How is leukocytosis diagnosed?

Your healthcare provider will perform an exam and ask about your symptoms and medical history. They’ll also order a complete blood count (CBC). This common blood test checks for red blood cells, white blood cells and platelets in your blood. A CBC can tell your healthcare provider if you have certain conditions or infections. In some cases, you might need a bone marrow test to confirm your diagnosis.

Management and Treatment

How is leukocytosis treated?

Treatment for leukocytosis varies depending on what caused the condition in the first place. For example, if you have a high white blood cell count due to a bacterial infection, then your healthcare provider will prescribe antibiotics. If leukocytosis is associated with an allergic reaction, then you’ll probably need antihistamines. Other common high white blood cell count treatments include:

  • Medications to reduce stress or anxiety.
  • Anti-inflammatory medications.
  • Inhalers to treat asthma.
  • IV fluids to improve blood flow.
  • Leukapheresis, a procedure to quickly reduce the number of white blood cells in your blood.
  • Cancer treatments, such as chemotherapy, radiation therapy or stem cell transplants.

In some cases, your white blood cell count may return to normal without intervention.

How long does it take to recover from leukocytosis treatment?

It depends on which type of treatment you receive. In most instances, you can recover from leukocytosis in two to four weeks. If you’re undergoing cancer treatment, it could take longer.

Prevention

Can I prevent leukocytosis?

Remember that leukocytosis is a normal immune response, so it doesn’t always need to be prevented. For example, your white blood cells increase when your body needs to fight off infection or inflammation. But, there are things you can do to keep your white blood cell count in a healthy range:

  • Wash your hands frequently to reduce the risk of infection.
  • Avoid potential allergens.
  • Don’t smoke.
  • Practice good dental hygiene.
  • Visit your dentist every six months.
  • Take all medications as directed by your healthcare provider.
  • Find ways to reduce your stress levels, like mindfulness or meditation.
  • Seek treatment for anxiety or depression as needed.

Outlook / Prognosis

What can I expect if I have leukocytosis?

If you have leukocytosis, your healthcare provider will run tests to determine why your white blood cell counts are elevated. Once the root cause has been identified, your healthcare provider will recommend appropriate treatment.

Living With

When should I see my healthcare provider?

It’s important to call your healthcare provider if something doesn’t seem quite right. Make an appointment if you experience:

  • Fever.
  • Easy bruising.
  • Excess bleeding.
  • Nausea and vomiting.
  • Fatigue.
  • Unexplained weight loss.
  • Poor appetite.
  • Soaking night sweats on a regular basis.

When should I go the ER?

If you develop any of the following symptoms, call 911 or head to your nearest emergency room:

  • Stroke symptoms, such as confusion, dizziness or facial drooping.
  • Chest pain.
  • Difficulty breathing.
  • Tingling in your arms, legs or abdomen.
  • Sudden back pain.
  • Bleeding that doesn’t stop.

A note from Cleveland Clinic

Most of the time, leukocytosis is a normal immune response caused by infection or inflammation. Sometimes, it’s associated with stress, anxiety or pregnancy. In some cases, however, a high white blood cell count could mean something more serious. That’s why it’s important to talk to your healthcare provider. They can determine the cause of leukocytosis and decide whether treatment is necessary.

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Last reviewed by a Cleveland Clinic medical professional on 01/19/2022.

References

  • American Association for Clinical Chemistry. White Blood Cell Count (WBC). (https://www.testing.com/tests/white-blood-cell-count-wbc/) Accessed 1/19/2022.
  • Brar RS, Schrier SL. Consultative Hematology. (https://accessmedicine.mhmedical.com/content.aspx?bookid=1581&sectionid=94301509) Williams Hematology, 9e New York, NY: McGraw-Hill. Accessed 1/19/2022.
  • Leukemia & Lymphoma Society. Understanding blood counts. (https://www.lls.org/managing-your-cancer/lab-and-imaging-tests/understanding-blood-counts) Accessed 1/19/2022.
  • Merck Manuals. Consumer Version. Overview of white blood cell disorders. (http://www.merckmanuals.com/home/blood-disorders/white-blood-cell-disorders/overview-of-white-blood-cell-disorders) Accessed 1/19/2022.
  • Riley LK, Rupert J. Evaluation of Patients with Leukocytosis. (https://www.aafp.org/afp/2015/1201/p1004.html) Am Fam Physician. 2015;92(11):1004-11. Accessed 1/19/2022.

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What is an alarming WBC count?

A blood test that shows a WBC count of less than 4,000 per microliter (some labs say less than 4,500) could mean your body may not be able to fight infection the way it should.

What does it mean when WBC is high or low?

Produced in your bone marrow, they defend your body against infections and disease. But, when there are too many white blood cells, it usually means you have infection or inflammation in your body. Less commonly, a high white blood cell count could indicate certain blood cancers or bone marrow disorders.

What happen if white blood cells are high?

A high white blood cell count usually indicates: An increased production of white blood cells to fight an infection. A reaction to a drug that increases white blood cell production. A disease of bone marrow, causing abnormally high production of white blood cells.

What diseases can a WBC detect?

Diseases of the immune system, such as HIV/AIDS. Lymphoma, a cancer of the bone marrow..
Autoimmune and inflammatory diseases, conditions that cause the immune system to attack healthy tissues..
Bacterial or viral infections..
Cancers such as leukemia and Hodgkin disease..
Allergic reactions..