Lymphocytosis: what can be and what to do

Lymphocytosis is a situation that occurs 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 CBC, the WBC, being considered lymphocytosis when more than 5000 lymphocytes are checked per mm³ of blood.

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

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

Main causes of lymphocytosis

Lymphocytosis is verified by means of the complete blood count, more specifically in the white blood cell count, which is the part of the blood count that contains information related to white blood cells, which are the cells responsible for the defense of the body, such as lymphocytes, leukocytes, monocytes, eosinophils and basophils.

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

1. Mononucleosis

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

As the lymphocytes act in defense of the organism, 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, CRP.

What to do: Generally this disease is eliminated naturally by the defense cells of the body itself, and can last from 4 to 6 weeks. However, the general practitioner may prescribe the use of some medications to relieve symptoms such as pain relievers and antipyretics to lower fever and anti-inflammatories to decrease pain. Find out how mononucleosis treatment is done.

2. Tuberculosis

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

In addition to high lymphocytes, the doctor may also see an increase in monocytes, called monocytosis, in addition to an increase in neutrophils. In case the person has symptoms of tuberculosis and suggestive changes in the blood count, the doctor may request a specific examination 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. See how to understand the PPD exam.

What to do: Treatment must be established by the pulmonologist or infectious disease, and the person must be monitored regularly. 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 the treatment is interrupted, it can proliferate again and bring consequences to the person.

The monitoring of the patient with tuberculosis should be done on a regular basis in order to check if there are still Koch bacilli, being necessary for that the person to do the sputum exam, being recommended the collection of at least 2 samples.

3. Measles

Measles is an infectious disease caused by a virus that mainly affects children up to 1 year old. This disease is considered highly contagious, as it can easily be transmitted from person to person through droplets released from 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 measles symptoms.

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

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

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, weight loss and appetite, swelling of 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 the blood of an infected person.

As hepatitis is caused by viruses, 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 WBC and blood count, which usually indicates anemia, the doctor must also assess 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 if it is caused by a virus, the use of antivirals, rest and increased fluid intake may be recommended by the infectologist, hepatologist or general practitioner. In the case of medicated hepatitis, the physician responsible for the replacement or suspension of the medicine responsible for liver damage should be recommended by the doctor. 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 the production of blood cells. This type of leukemia is called acute because the lymphocytes recently manufactured 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 are unable to 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 blood pressure. platelet count.

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

What to do: It is important to see 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 so that more specific tests can be 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, bone marrow transplantation is recommended. See how the bone marrow transplant is done.

6. Chronic Lymphocytic Leukemia

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

Often the LLC does not cause symptoms, but they can appear in some cases, such as underarm, groin or neck swelling, night sweating, pain in the left side of the belly caused by an enlarged spleen and fever. It is a disease that mainly affects the elderly and women aged over 70 years.

What to do: An evaluation by a general practitioner is essential and in cases where the disease is confirmed, referral to a hematologist is required. The hematologist will confirm the disease through other tests, including bone marrow biopsy. In the case of confirmation of the LLC, the doctor indicates the start 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 it 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, the symptoms being very similar among them as lumps in the neck, groin, clavicle, belly and armpit, in addition to fever, sweat night, weight loss without apparent cause, shortness of breath and cough.

What to do: With the onset of symptoms it is recommended to see 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 disease. Treatment will only be indicated after the doctor has defined the degree of the disease, but chemotherapy, radiation therapy and bone marrow transplantation are usually performed.