{"id":4103,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/lymphocytosis\/"},"modified":"2026-07-24T13:29:01","modified_gmt":"2026-07-24T12:29:01","slug":"lymphocytosis","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/haematology\/lymphocytosis\/","title":{"rendered":"Lymphocytosis"},"content":{"rendered":"\n<h4 class=\"wp-block-heading\">Definition <\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Lymphocyte count on FBC in an adult patient that is greater than the upper limit of the normal range: please only refer if above 10 x 10<sup>9<\/sup>\/l, unless the patient has other symptoms in which case the threshold is lower (see below).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Lymphocytosis is common and is usually a reactive response that does not require any intervention. It occurs in viral infections, autoimmune disorders including connective tissue disorders, thyroiditis, diabetes etc. It is frequent in smokers and post splenectomy.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C.M &amp; L.W 24-7-26<\/strong><\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\">Who to refer:<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Please refer:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Symptomatic patients (significant unintentional weight loss, fever, new persistent drenching night sweats) with a lymphocyte count &gt;5 x 10<sup>9<\/sup>\/l<\/li>\n\n\n\n<li>Patients with lymphadenopathy (nodes &gt;1 cm) and\/or splenomegaly and\/or cytopenias (Hb &lt;100, neutrophils &lt;1.0, platelets &lt;100) with a lymphocyte count &gt;5 x 10<sup>9<\/sup>\/l<\/li>\n\n\n\n<li>Patients with a lymphocyte count &gt;10 x 10<sup>9<\/sup>\/l for &gt;3 months on repeat testing.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Please refer URGENTLY:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>symptomatic patients or if there is presence of lymphadenopathy or splenomegaly.<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Who not to refer:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Asymptomatic patients with a single lymphocyte count &gt;10 x 10<sup>9<\/sup>\/l. Instead repeat FBC in 3 months.<\/li>\n\n\n\n<li>Asymptomatic patients with a lymphocyte count of 5-10 x 10<sup>9<\/sup>\/l. Instead repeat FBC in 6 months and if minimal change repeat FBC annually thereafter.<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">How to refer:<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">SCI Gateway to the Department of Haematology WGH or SJH.<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care  Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<ul class=\"wp-block-list\">\n<li>FBC<\/li>\n\n\n\n<li>Blood film.<\/li>\n\n\n\n<li>LFTs.<\/li>\n\n\n\n<li>Viral serology for EBV (IgM), CMV (IgM), HIV &amp; Hepatitis viruses (HepBs Ag, HepB core Ab, HepC Ab)<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and  Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p class=\"wp-block-paragraph\"><a href=\"http:\/\/intranet.lothian.scot.nhs.uk\/Directory\/Haematology\/Clinical%20Management%20Guidelines\/Documents\/The%20signficance%20of%20lymphocytosis%20in%20routine%20clinical%20practice%20-%20BHS%202021.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">The significance of lymphocytosis in routine clinical practice: data from the South East Scotland Cancer Network<\/a><br>Gabrielle E. Clark, Christopher Mullen, Laura E. McGlinchey, Victoria Campbell.<\/p>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Definition Lymphocyte count on FBC in an adult patient that is greater than the upper limit of the normal range: please only refer if above 10 x 109\/l, unless the patient has other symptoms in which case the threshold is lower (see below). Lymphocytosis is common and is usually a reactive response that does not<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":3981,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_searchwp_excluded":"","footnotes":""},"categories":[263],"class_list":["post-4103","page","type-page","status-publish","hentry","category-lymphocytosis"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/haematology\/lymphocytosis\/\" rel=\"tag\">Lymphocytosis<\/a>","rttpg_excerpt":"Definition Lymphocyte count on FBC in an adult patient that is greater than the upper limit of the normal range: please only refer if above 10 x 109\/l, unless the patient has other symptoms in which case the threshold is lower (see below). Lymphocytosis is common and is usually a reactive response that does not","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4103","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=4103"}],"version-history":[{"count":12,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4103\/revisions"}],"predecessor-version":[{"id":29149,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4103\/revisions\/29149"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3981"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=4103"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=4103"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}