Malignancy, especially monocytic leukemia, should always be investigated in a patient with monocytosis and appropriate symptom features.
Monocytosis can also develop during the recovery phase of an acute infection, recovery from granulocytosis, or be representative of extremely rare pediatric conditions, such as congenital agranulocytosis. Finally, monocytosis exists in a chronic, poorly defined idiopathic condition which is a diagnosis of exclusion.
All of the above conditions are mere examples, however, as a definitive list would be too broad to cover in this text. History taking for patients with monocytosis is critical in deciphering the meaning of this sign. A thorough infectious history should be taken including fevers, unintentional weight loss, upper and lower respiratory symptoms, bowel distress and abdominal symptoms, dysuria, rashes, travel history, sick contacts, headaches, a sexual history, etc.
Finally, and perhaps most importantly, a family history for rheumatologic, malignant, or genetic diseases should be undertaken in addition to a thorough past medical history. There is no single maneuver used to evaluate monocytosis, but rather a general approach for infectious or chronic disease should be undertaken. A general exam for infectious causes, especially those of chronic infections, can be used, specifically examining for lymphadenopathy, rashes, genital lesions including chancre, signs of weight loss and cachexia including temporal wasting, seborrheic dermatitis, clubbing, janeway lesions, osler nodes, etc.
Petechiae and splenomegaly can be hallmark signs of blood related malignancies, while a proper rheumatologic examination should include all of the aforementioned in addition to joint and skin inspection looking for effusions, inflammation, palpable purpura and synovitis as well as examination of the oral cavity looking for ulcers, and eye exams for dryness or inflammation.
MonoMAC syndrome. White Blood Cell Disorders. Test your knowledge. Acute myeloid leukemia AML is a life-threatening disorder in which certain blood cells become cancerous and rapidly replace normal cells in the bone marrow. As normal blood cells are replaced by cancerous cells, people with AML become anemic from too few red blood cells.
They develop infections easily because there are too few white blood cells to fight infections, and their blood does not clot well because of too few platelets.
Which of the following additional symptoms of AML may be caused by having too few white blood cells? More Content. Diagnosis is by a blood test that shows the absence of monocytes and by genetic testing. Was This Page Helpful?
Yes No. Overview of White Blood Cell Disorders. Laboratory Tests for Blood Disorders. An infection by a bacteria, virus or fungus can cause an increase in monocyte levels. This is because the body creates more monocytes to fight the invader. An absolute monocytes high can also be a response to stress, chronic infections or autoimmune disorders. Sometimes, a count outside of the normal absolute monocytes range may suggest that there is a problem with the way the body produces new blood cells.
This can indicate certain types of blood conditions. Macrophages are monocytes that have finished their tasks in the bloodstream, and have moved to other organs or tissues in the body and matured. It can also tell if some types of white blood cells are abnormal or immature.
The blood differential test is done the same way as most other blood tests. A sample of blood will be drawn from your arm. Once your blood is drawn, a special dye helps the pathologist count the different types of white blood cells in your blood sample.
Looking at monocytes alone may not give you the whole picture. This report may refer to it as a leukocyte count. Monocytes typically make up a fairly small percentage of your white blood cells. The normal range of each type of white blood cell is:. When your monocyte level is high — known as monocytosis — it means your body is fighting something.
Having too many monocytes is also the most common sign of chronic myelomonocytic leukemia. This is a type of cancer that begins in the cells that produce blood in bone marrow. A recent study suggests a higher monocyte count may be related to cardiovascular disease, and that early detection of increased monocytes could help assess heart health management.
More large-scale research is needed to confirm this. For example, a study found that a high-monocyte-to-low-lymphocyte ratio can help identify disease activity in people with ulcerative colitis. Treatment of elevated monocytes depends on the cause.
Your doctor may have to do more tests to determine the underlying cause.
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