What does increased lymphocytes mean?
Lymphocytes are part of the immune system: they recognize viruses and altered cells, produce antibodies and store immune memory. When the body encounters a virus, lymphocytes actively multiply and their number in the blood increases. This is a defensive reaction, not a disease. In children, the normal proportion of lymphocytes is noticeably higher than in adults, so children's tests cannot be assessed according to adult standards. Much more informative is the absolute number of lymphocytes, which the laboratory indicates as a separate line.
- Relative lymphocytosis - the proportion increases with a normal amount
- Absolute lymphocytosis - the sheer number of cells increases
- Reactive lymphocytosis - response to infection
- Clonal lymphocytosis - reproduction of one altered clone
- Physiological lymphocytosis in young children
Reasons
Most often, lymphocytosis is associated with viral infections: acute respiratory infections, infectious mononucleosis, chickenpox, viral hepatitis. In mononucleosis, the lymphocytes change appearance and the laboratory describes them as atypical mononuclear cells. An increase is also possible with whooping cough, tuberculosis, and toxoplasmosis. A separate group of reasons are conditions in which lymphocytes are redistributed: stress, trauma, removed spleen, smoking. In older adults, persistent absolute lymphocytosis without infection leads to the exclusion of chronic lymphocytic leukemia.
- Acute viral infections
- Infectious mononucleosis
- Viral hepatitis, HIV
- Whooping cough in children
- Tuberculosis, toxoplasmosis, brucellosis
- Stress, trauma, condition after removal of the spleen
- Smoking
- Chronic lymphocytic leukemia and lymphomas
Associated symptoms
Lymphocytosis itself does not cause complaints, so the doctor relies on the accompanying symptoms. With an infectious nature, there is usually a fever, sore throat, weakness, enlarged and painful cervical lymph nodes, sometimes a rash and an enlarged liver and spleen. These symptoms go away as you recover. Another alarming picture is a long-term, gradually increasing enlargement of painless lymph nodes in several areas, night sweats with the need to change underwear, unexplained weight loss and recurring infections.
- Fever and sore throat due to infection
- Painful cervical lymph nodes
- Weakness and fatigue
- Painless dense lymph nodes in tumor diseases
- Night sweats and weight loss
- Enlarged spleen
What examinations are needed
In a typical situation, after a viral infection, the test is simply repeated after 4-6 weeks: in most people the indicator returns to normal, and nothing further is required. If lymphocytosis persists, the doctor evaluates the lymph nodes, liver and spleen, and prescribes tests for possible infections. With persistent absolute lymphocytosis in an adult, the key study is immunophenotyping of blood lymphocytes, which shows whether we are talking about a reactive reaction or a clonal process. If the lymph nodes are enlarged, a biopsy may be required.
- Repeat general blood test with formula in 4–6 weeks
- Examination of lymph nodes, liver and spleen
- Tests for viral infections, including HIV and hepatitis
- C-reactive protein
- Ultrasound of lymph nodes and abdominal cavity
- Chest X-ray for suspected tuberculosis
- Immunophenotyping of lymphocytes as prescribed by a hematologist
- Lymph node biopsy with persistent enlargement
What to do and how to treat it
Reactive lymphocytosis does not require treatment: it disappears along with the cause. There are no special drugs that reduce lymphocytes during a normal immune reaction, and attempts to take something to improve the analysis are pointless. If a specific infection is found, it is treated. When detecting chronic lymphocytic leukemia, tactics depend on the stage: in the early stages, in the absence of symptoms, observation with regular tests is often chosen, and treatment begins when it progresses. The hematologist makes all decisions.
- Repeated testing instead of self-medication
- Treatment of identified infection
- Quitting smoking
- Observation of a hematologist for clonal lymphocytosis
- Regular monitoring of blood tests at scheduled times
- Seeing a doctor if you have new symptoms
