II. Definitions
- Neutrophil
- Scavenger, granulocytic White Blood Cell, among the first immune cell to respond to infection sites
- As with other Phagocytes (Macrophages), Neutrophils engulf foreign material and organisms and lyse them
- Left Shift
- Increased number of immature Neutrophils (band forms)
- Suggests acute inflammation
III. Characteristics
- Neutrophils form in Bone Marrow from Myeloblasts as with other Granulocytes (Basophils, Eosinophils, Monocytes)
- Neutrophils are scavenger, granulocytic White Blood Cell, among the first immune cell to respond to infection sites
- Neutrophils are short-lived cells that survive for only 1-2 days
- Function: Primary defense against Bacterial Infection
- Neutrophils engulf foreign material (Phagocytosis) and organisms and lyses/digests them
- Responds to several sources of chemotaxins
- Macrophage released Interleukin
- Basophil and Mast Cell released Histamine
- C-Reactive Protein Induced Complement Activation
- Morphology on Blood Smear
- Granulocyte with neutral staining on Wright Stain
- Nucleus with 3 to 5 lobes connected by thin chromatin
- Cytoplasm with fine granules
IV. Interpretation: Normal Count
- Range: 50-70% of White Blood Cells
- Bands: 2-6% of White Blood Cells
- Absolute Neutrophil Count (ANC) >1500 Neutrophils/mm3
V. Causes: Decreased Neutrophils
- See Neutropenia
VI. Causes: Increased (Neutrophilia) - ANC > 7500/mm3
- Acute Bacterial Infection (and other infections)
- Reactive Neutrophilia (Physiologic Increase, Demargination)
- Release of cells in marginal pool
- Mediated by stress (Stress Leukocytosis)
- Exercise
- Seizures
- Anxiety
- Epinephrine
- Tobacco use
- Post-operative state
- Tissue Injury
- Chronic Inflammation
- Rheumatic disease
- Inflammatory Bowel Disease
- Vasculitis
- Chronic Hepatitis
- Metabolic condition
- Myeloproliferative disorder
- Myelocytic Leukemia
- Myeloid metaplasia
- Polycythemia Vera
- Miscellaneous causes
- Hemolytic Anemia
- Acute Hemorrhage
- Splenectomy (Leukocytosis may persist for months)
- Immune Thrombocytopenia
- Neoplasms
- Metastatic cancer
- Congenital
- Down Syndrome
- Leukocyte adhesion deficiency
- Medications
VII. Evaluation: Neutrophilia (Neutrophils >7000/mm3)
- See Leukocytosis
- Consider history and potential causes
- Travel and contagious contacts
- Social history
- New medications
- Diagnostics (consider)
- Infection source evaluation
- Urinalysis
- Chest XRay
- Lumbar Puncture
- Blood Cultures (2 sets or if SBE suspected, 3 sets)
- Acute phase reactants
- Other labs
- Rheumatologic studies (e.g. Antinuclear Antibody)
- Infection source evaluation
VIII. References
- Wilson (1991) Harrison's Medicine, McGraw, p. 360-1
- Riley (2015) Am Fam Physician 92(11):1004-11 [PubMed]
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Related Studies
| Definition (NCI) | Granular leukocytes having a nucleus with three to five lobes connected by slender threads of chromatin, and cytoplasm containing fine inconspicuous granules and stainable by neutral dyes. |
| Definition (NCI_NCI-GLOSS) | A type of immune cell that is one of the first cell types to travel to the site of an infection. Neutrophils help fight infection by ingesting microorganisms and releasing enzymes that kill the microorganisms. A neutrophil is a type of white blood cell, a type of granulocyte, and a type of phagocyte. |
| Definition (MSH) | Granular leukocytes having a nucleus with three to five lobes connected by slender threads of chromatin, and cytoplasm containing fine inconspicuous granules and stainable by neutral dyes. |
| Definition (CSP) | granular leukocytes having a nucleus with three to five lobes connected by slender threads of chromatin, and cytoplasm containing fine inconspicuous granules and stainable by neutral dyes. |
| Concepts | Cell (T025) |
| MSH | D009504 |
| SnomedCT | 259710001, 80153006, 116712007 |
| LNC | LP16686-5, LP14267-6, LP17840-7, MTHU044811, MTHU006207, MTHU009212 |
| English | Leukocyte, Polymorphonuclear, Leukocytes, Polymorphonuclear, Neutrophils, Polymorphonuclear Leukocyte, Polymorphonuclear Leukocytes, heterophil granulocyte, neutrophilic granulocyte, Neutrophil, Neutrophile, Heterophile leucocyte, Neutrophil leukocyte, Neutrophil leucocyte, Blood neutrophils, polymorphonuclear leukocytes, polymorphonuclear cells, polymorph, polymorphonuclear neutrophil, polymorphonuclear cell, neutrophils, polymorphonuclear neutrophils, neutrophilic leukocyte, polymorphs, cells pmn, Neutrophil (cell), Polymorphonuclear cells/leukocytes, Polymorphonuclear cells, polymorphonuclear leukocyte, PMN, PMN cell, Polymorphonuclear leucocyte, Polymorphonuclear leukocyte (cell), Polymorphonuclear leukocyte, Neutrophil (body structure), Polymorphonuclear Cell, Polymorphonuclear Neutrophils, neutrophil, Polymorph, PMN - polymorphonuclear leucocyte, PMN - polymorphonuclear leukocyte, Polys |
| Dutch | neutrofielen, bloed neutrofielen, Leukocyt, polymorphonucleair, Neutrofyl, Neutrofylen, Polymorphonucleaire leukocyt |
| French | Neutrophiles sanguins, Neutrophiles, Granulocytes neutrophiles, PNN (Polynucléaire neutrophile), Polynucléaire neutrophile, Polynucléaires neutrophiles, Granulocyte neutrophile |
| German | Neutrophile im Blut, Leukozyten, polymorphkernige, Neutrophile, Polymorphkernige Leukozyten |
| Italian | Neutrofili ematici, Leucociti polimorfonucleari, Neutrofili |
| Portuguese | Neutrófilos no sangue, Leucócitos Polimorfonucleares, Neutrófilos |
| Spanish | Neutrófilos en sangre, neutrófilo polimorfonuclear, neutrófilo, neutrófilo (célula), leucocito polimorfonuclear (célula), leucocito polimorfonuclear, neutrófilo (estructura corporal), Leucocitos Polimorfonucleares, Neutrófilos |
| Japanese | 血中好中球, ｹｯﾁｭｳｺｳﾁｭｳｷｭｳ, ｺｳﾁｭｳｷｭｳ, 白血球-多形核, 多核白血球, 多形核白血球, 多形核球, LE細胞, 好中球 |
| Swedish | Neutrofila leukocyter |
| Czech | neutrofily, granulocyty neutrofilní, leukocyty polymorfonukleární, Neutrofily v krvi, Neutrofily |
| Finnish | Neutrofiilit |
| Russian | NEITROFILY, LEIKOTSITY POLIMORFNOIADERNYE, GRANULOTSITY NEITROFIL'NYE, LEIKOTSITY NEITROFIL'NYE, LE-KLETKI, LE-КЛЕТКИ, ГРАНУЛОЦИТЫ НЕЙТРОФИЛЬНЫЕ, ЛЕЙКОЦИТЫ НЕЙТРОФИЛЬНЫЕ, ЛЕЙКОЦИТЫ ПОЛИМОРФНОЯДЕРНЫЕ, НЕЙТРОФИЛЫ |
| Croatian | NEUTROFILI |
| Latvian | Polimorfonukleārie leikocīti, Neitrofili, Leikocīti, polimorfonukleārie |
| Polish | Neutrofile, Granulocyty obojętnochłonne, Komórki LE, Leukocyty wielojądrzaste |
| Hungarian | Neutrofilek, Neutrofil vérszint |
| Norwegian | Leukocytter, nøytrofile, Nøytrofile leukocytter, Nøytrofile celler |
Ontology: Neutrophilia (finding) (C0151683)
| Definition (NCI) | Abnormally high level of neutrophils in the blood.(NICHD) |
| Concepts | Laboratory or Test Result (T034) |
| SnomedCT | 165518003 |
| Italian | Conta dei neutrofili aumentata, Neutrofili aumentati, Conta dei neutrofili elevata |
| Dutch | neutrofielen verhoogd, neutrofielentelling hoog, neutrofielentelling verhoogd |
| French | Numération des neutrophiles élevée, Neutrophiles augmentés |
| German | Neutrophile erhoeht, Neutrophilenzahl hoch, Neutrophilenzahl erhoeht |
| Portuguese | Neutrófilos aumentados, Número de neutrófilos alto, Número de neutrófilos aumentado |
| Spanish | Neutrófilos elevados, Recuento alto de neutrófilos, leucocitosis neutrofílica, neutrofilia (hallazgo), neutrofilia, Recuento elevado de neutrófilos |
| Japanese | 好中球数増加, 好中球増加, ｺｳﾁｭｳｷｭｳｽｳｿﾞｳｶ, ｺｳﾁｭｳｷｭｳｿﾞｳｶ, ｺｳﾁｭｳｷｭｳｽｳｺｳﾁ, 好中球数高値 |
| Czech | Počet neutrofilů zvýšený, Vzestup neutrofilů, Vysoký počet neutrofilů |
| English | Neutrophil count high, Neutrophil count increased, increased neutrophil count, increased neutrophil, count high neutrophils, counts high neutrophil, elevated neutrophil, high neutrophil count, increased neutrophils, neutrophil elevated, count high neutrophil, elevated neutrophils, Neutrophils increased, Neutrophil count above reference range, Neutrophilia (finding), Neutrophilic leukocytosis, Neutrophilia, Neutrophilic leucocytosis |
| Hungarian | Neutrofilek emelkedett, Neutrofil szám emelkedett, Neutrofil szám magas |
Ontology: Neutrophil count (procedure) (C0200633)
| Definition (NCI) | A test to determine the number of neutrophils in a sample of blood. |
| Concepts | Laboratory Procedure (T059) |
| SnomedCT | 142931003, 165515000, 165520000, 142926000, 30630007 |
| English | Neutrophil count NOS, Neutrophil Count, seg (blood count), poly count, blood neutrophil count (lab test), blood neutrophil count, Neutrophil count (procedure), count polys, counts neutrophil, count neutrophils, neutrophil count, blood count segs, count neutrophil, counts neutrophils, Neutrophil count NOS (procedure), Neutrophil count, Neutrophil count [dup] (procedure) |
| Italian | Conta dei neutrofili |
| Japanese | 好中球数, ｺｳﾁｭｳｷｭｳｽｳ |
| Czech | Počet neutrofilů |
| Hungarian | Neutrofil szám |
| Spanish | Neutrophil count NOS, recuento de neutrófilos, SAI (procedimiento), recuento de neutrófilos, SAI, recuento de neutrófilos (procedimiento), recuento de neutrófilos, Recuento de neutrófilos |
| Portuguese | Número de neutrófilos |
| Dutch | neutrofielentelling |
| French | Neutrophiles |
| German | Neutrophilenzahl |
Ontology: Left shifted white blood cells (C0240173)
| Concepts | Finding (T033) |
| SnomedCT | 87361006 |
| LNC | LP19259-8, MTHU007796 |
| Italian | Deviazione a sinistra, Deviazione a sinistra (ematologica) |
| Dutch | linksverschuiving (hematologisch), verschuiving naar links (hematologisch), verschuiving naar links |
| French | Déviation à gauche (hématologique), Glissement vers la gauche |
| German | Linksverschiebung (haematologisch), Linksverschiebung |
| Portuguese | Desvio para a esquerda (hematológico), Virar para a esquerda |
| Spanish | Desviación a la izquierda (hematológica), alteración de la maduración leucocítica con desviación hacia la izquierda (hallazgo), alteración de la maduración leucocítica con desviación hacia la izquierda, desviación hacia la izquierda del recuento de glóbulos blancos, recuento de glóbulos blancos con desviación hacia la izquierda, Desviación a la izquierda |
| Japanese | 左方移動, 左方移動（血液学的）, ｻﾎｳｲﾄﾞｳ, ｻﾎｳｲﾄﾞｳｹﾂｴｷｶﾞｸﾃｷ |
| English | Left shift leukocytic maturation alteration, shift to the left, blood cells left shift white, left shift, left shift wbc, left shift of wbc, left shifting, left shifting wbc, wbc left shift, Shift to the left (haematological), Shift to the left (hematological), Shift to the left, Leukocytes.left shift, Left shift, Left shift of WBC, Left shifted white blood cells, Left shifted white blood cells (finding) |
| Czech | Posun doleva (hematologický), Posun doleva |
| Hungarian | Balra tolódás (hematológiai), Balra tolódás |
