In this article, we look at the reasons for high or low neutrophil levels, how doctors can test these levels, and what normal neutrophil levels are for different groups. There are many different reasons why a person may have higher or lower than normal levels of neutrophils in their blood. Having an abnormally high level of neutrophils in the blood is known as neutrophilic leukocytosis, also known as neutrophilia.
Rises in neutrophil levels usually occur naturally due to infections or injuries. However, neutrophil blood levels may also increase in response to:. Some inflammatory conditions can increase neutrophil levels, including rheumatoid arthritis , inflammatory bowel disease, hepatitis , and vasculitis.
A drop in neutrophil blood levels typically occurs when the body uses immune cells faster than it produces them or the bone marrow is not producing them correctly. An enlarged spleen may also cause a decrease in neutrophil levels because the spleen traps and destroys neutrophils and other blood cells.
Some specific conditions, procedures, and drugs that interfere with neutrophil production include:. Doctors can identify changes in neutrophil levels from a blood test called a complete blood count CBC with differential, which identifies specific groups of white blood cells. A doctor may order a CBC test when someone is experiencing a range of symptoms related to infection, chronic illness, and injury, such as fever , pain, and exhaustion.
A nurse or technician will draw a small amount of blood from the arm and send it off for evaluation. If the initial test shows a higher or lower number of white blood cells than normal, the doctor will likely repeat the test to confirm the results.
If there is no apparent reason for changes in white blood cell levels, the doctor will order a more specific test. Laboratory specialists will look for specific white blood cells, such as immature neutrophils called myeloblasts.
During an infection or chronic illness, these cells emerge from the bone marrow and mature in the blood instead of the bone marrow. If myeloblasts or other white blood cells appear in significant levels in the blood, the doctor will request a bone marrow sample. Bone marrow collection involves inserting a long needle into part of the pelvis near the back of your hip. The procedure can be very painful, and a doctor will typically take the sample in a hospital setting with at least a local anesthetic.
Experts will examine the bone marrow sample to see if neutrophils and other blood cells are developing correctly and are in regular supply. If the cause of the high or low neutrophil levels is still uncertain, the doctor will order other tests to try to pinpoint the cause of the changes, such as:. Changes in neutrophil levels are often a sign of more significant changes in white blood cell levels.
Talk to anyone on the care team about ways to find support. You also can visit online sites for more information and support, such as:. Reviewed by: Jonathan L. Powell, MD. Larger text size Large text size Regular text size. What Is Neutropenia? Compared with other kids, a child with neutropenia may have infections: more often that are more severe that get worse quickly The symptoms depend on what kind of infection the child has for example, ear pain in a child with an ear infection.
What Causes Neutropenia? Accessed Dec. Berliner N. Approach to the adult with unexplained neutropenia. Goldman L, et al. Leukocytosis and leukopenia. In: Goldman-Cecil Medicine. Philadelphia, Pa.
Bope ET, et al. In: Conn's Current Therapy McPherson RA, et al. Leukocytic disorders. Louis, Mo. If your neutrophil count is low, the doctor may say you are neutropenic. For most people with cancer, having a low neutrophil count is the biggest risk factor for getting a serious infection.
Ask your doctor if your cancer treatment will cause your neutrophil count to drop. Some treatments, most often those given during a bone marrow stem cell transplant , can cause a shortage of lymphocytes. B and T lymphocytes help fight viruses, but have different jobs:. You might hear your doctor or nurse talk about your absolute neutrophil count or ANC. This is the number of neutrophils you have in a certain amount of blood.
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