Definition
Increase in neutrophils on FBC differential.
Neutrophilia is frequently ‘reactive’, associated with acute infection/active inflammation or acute stress eg acute bleed. Haematological causes possible with significant persistent increase over 1-2 months in the absence of underlying reactive cause. Blood film comments may show circulating immature forms eg myelocytes/nucleated red cells or aniso/poikilocytosis.
C.M & L.W 31-07-23
Who to refer:
Patients with significant persistent neutrophilia >15 after 4-6 weeks with any of the following:
- no obvious cause such as inflammation
- additional abnormalities on blood film comments, eg presence of myelocytes or nucleated red cells or significant poikilocytosis
- significant anaemia or thrombocytosis/thrombocytopenia
- blood count/film reported as suggestive of chronic myeloid leukaemia
- splenomegaly.
Who not to refer:
Transient neutrophilia or persistent mild neutrophilia <15. This is most likely caused by chronic inflammatory or infective processes.
May be associated with smoking.
How to refer:
SCI Gateway to the Department of Haematology at WGH or St John’s.
Primary care investigations
- FBC + film
- Biochemistry including renal function, liver function, LDH calcium, albumin, urate
- Inflammatory markers, ESR, CRP
- Check smoking history including e-cigarettes.
