{"id":4153,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/monocytosis\/"},"modified":"2023-08-31T14:20:14","modified_gmt":"2023-08-31T13:20:14","slug":"monocytosis","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/haematology\/monocytosis\/","title":{"rendered":"Monocytosis"},"content":{"rendered":"\n<title>Monocytosis<\/title>\n\n\n\n<h4 class=\"wp-block-heading\">Definition&nbsp; <\/h4>\n\n\n\n<p>Monocyte count above normal range.<\/p>\n\n\n\n<p>Monocytosis is most commonly caused by chronic inflammatory or infective problems \u2013 consider TB, SBE, SLE, rheumatoid arthritis, temporal arteritis. Please see Primary Care Management for further detail.<\/p>\n\n\n\n<p>Cigarette smoking is a common cause of mild monocytosis.<\/p>\n\n\n\n<p>Myelodysplasia<\/p>\n\n\n\n<p>The major alternative diagnosis to be considered in patients with monocytosis is myelodysplasia (WHO subtype chronic myelomonocytic leukaemia).&nbsp; This is a clonal marrow disorder often causing peripheral blood cytopenias and macrocytosis in addition to the monocytosis.&nbsp; It generally requires a bone marrow test for confirmation of diagnosis.&nbsp; Treatments are available and may include blood transfusion or other therapies.&nbsp;<\/p>\n\n\n\n<p>Suggest however that this diagnosis is not discussed in primary care \u2013 there are many subtypes of myelodysplasia ranging from a very benign disorder requiring no treatment, to an extremely serious disorder very close to acute myeloid leukaemia.&nbsp; Much of the literature available on the internet concentrates on the more aggressive subtypes.<\/p>\n\n\n\n<p><strong>C.M &amp; L.W 26-06-23<\/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><strong>Please refer:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Patients with no evidence of an inflammatory or infective problem and unexplained persistent (&gt;3\/12) monocytosis &gt;1.5 (&gt;2.0 in cigarette smokers &#8211; including e-cigarettes)<\/li>\n\n\n\n<li>Patients with monocytosis &gt;1.5 with any additional full blood count abnormality \u2013 e.g. anaemia, macrocytosis, neutropenia, thrombocytopenia, or combinations of abnormalities.<\/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>Monocytosis with evidence of an inflammatory or infective cause should be referred to Infectious Diseases, Rheumatology, or other as appropriate rather than to haematology.&nbsp;<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">How to refer:<\/h4>\n\n\n\n<p>SCI Gateway to the Department of Haematology WGH or St Johns.<\/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<h3 class=\"wp-block-heading\">Primary care investigations<\/h3>\n\n\n\n<p>When first identified if monocyte count&nbsp; &gt;2.0 repeat at 6 weeks. If monocyte count &gt;0.80 but &lt; 2.0 repeat at 3 months. <\/p>\n\n\n\n<p>If monocytosis resolved no further tests are needed.<\/p>\n\n\n\n<p>If monocytosis persists then:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Blood film<\/li>\n\n\n\n<li>ESR<\/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\"><\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Monocytosis Definition&nbsp; Monocyte count above normal range. Monocytosis is most commonly caused by chronic inflammatory or infective problems &ndash; consider TB, SBE, SLE, rheumatoid arthritis, temporal arteritis. Please see Primary Care Management for further detail. Cigarette smoking is a common cause of mild monocytosis. Myelodysplasia The major alternative diagnosis to be considered in patients with<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":3981,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[266],"class_list":["post-4153","page","type-page","status-publish","hentry","category-monocytosis"],"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\/monocytosis\/\" rel=\"tag\">Monocytosis<\/a>","rttpg_excerpt":"Monocytosis Definition&nbsp; Monocyte count above normal range. Monocytosis is most commonly caused by chronic inflammatory or infective problems &ndash; consider TB, SBE, SLE, rheumatoid arthritis, temporal arteritis. Please see Primary Care Management for further detail. Cigarette smoking is a common cause of mild monocytosis. Myelodysplasia The major alternative diagnosis to be considered in patients with","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4153","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=4153"}],"version-history":[{"count":8,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4153\/revisions"}],"predecessor-version":[{"id":16131,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4153\/revisions\/16131"}],"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=4153"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=4153"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}