Are there too many lymphocytes in the blood report? (Lymphocytosis) - Let's talk about this

Have you recently had a full blood count (FBC)? You may have been a little alarmed when you saw that the number in front of the 'Lymphocytes' value on that report was slightly elevated. Many people think, "Oh my, is this something serious?" But in reality, most of the time this means that your body is fighting off an infection. It means that your immune system is working properly! So without further ado, let's understand exactly what this increase in lymphocytes, or as it is medically called, 'Lymphocytosis', is.

Simply put, what is Lymphocytosis?

Okay, first let's see who these lymphocytes are. Imagine that your body is like a country. Then the white blood cells in your blood are the army of that country. There are different branches of this army. One such special branch is the lymphocytes . Their main job is to find enemies like viruses and bacteria that enter our body, fight against them, and protect us from diseases.

So, Lymphocytosis is when those "soldiers" called lymphocytes are in your blood at a higher than normal number. Normally, when an adult has more than 4,000 lymphocytes per microliter of blood, we call that condition Lymphocytosis.

What are the possible causes of increased lymphocytes?

There is not one reason for the increase in lymphocytes, there can be many reasons. But the main reason we often see is infection. But in addition to that, other factors can also affect it. Let's look at the table below to understand these clearly.

What are the symptoms of this?

This is the most important thing. There are no symptoms that are specific to the condition called lymphocytosis.

Imagine that a burglar breaks into your house and the security alarm goes off. The alarm going off is not a disease, it's just a signal that something is wrong with the house. You're not bothered by the sound of the alarm, but by the burglar.

Lymphocytosis is like that alarm. It tells you that there is something wrong with your body (usually an infection). So you are experiencing symptoms because of that underlying cause.

For example:

• If the cause is a cold, you may have symptoms like fever, body aches, cough, and runny nose .
• If the cause is mononucleosis, you may have a sore throat, severe fatigue, and swollen glands in your neck .

Most of the time, people find out about this by accident when they get a blood test done for another reason.

How does the doctor detect and confirm this?

If your FBC report shows high lymphocytes, your doctor will take several steps to find the cause.

1. You will be asked about your details: First, you will be asked questions. Things like, "Have you had a fever recently?", "Have you started any new medications?", "Do you smoke?", "Are you taking any other medications?"

2. Physical examination: Next, you will be examined. Things like checking your throat, chest, and whether your gums are swollen can help to determine the cause.

3. Repeating the blood test: Most of the time, the doctor will say, "Don't worry, we'll do another FBC in a week or two." Because, if it's a simple infection, the lymphocyte count will go back to normal as it gets better.

4. Referral to a specialist: If the value remains high, or if there are other suspicious symptoms, you may be referred to a doctor who specializes in blood-related diseases, a hematologist .

5. Additional tests: If necessary, the specialist may order additional tests to find the exact cause. For example, a Flow Cytometry test, which studies the type and nature of blood cells in depth, or a Bone Marrow Biopsy. However, these are only done in cases of extreme necessity.

How is this treated?

Here again, we need to remember the example of the alarm. We are not treating the alarm, but the thief. Also, we are not treating the lymphocyte count, but the underlying disease condition that caused it.

• If the cause is a viral infection: In most cases, no special treatment is needed. Get plenty of rest and drink plenty of fluids (water, porridge, soup). Your body's immune system will take care of it.
• If the cause is a bacterial infection: The doctor will prescribe appropriate antibiotics.
• If the cause is a serious condition such as cancer: This will be a specific treatment depending on the type of cancer involved. Your medical team will explain this to you in detail.

Once the underlying cause is treated, lymphocyte levels gradually return to normal.

The question that everyone fears: Can an increase in lymphocytes be leukemia?

This is a big fear in many people's minds. But in reality, lymphocytosis caused by a common infection does not turn into leukemia.

However, sometimes there is a condition called Monoclonal B-cell lymphocytosis (MBL) . This is when a special type of cell called B-lymphocyte starts to behave in a slightly abnormal way. A small percentage of people with this MBL condition (about 1% per year) may develop a leukemia called Chronic Lymphocytic Leukemia (CLL) over time.

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