HNY Policy and Pathway Repository - North Yorkshire

Neutrophil count elevated

If chronic myeloid leukaemia is suspected patient to be contacted by a haematologist to organise urgent admission or outpatient review and further investigations as indicated. 

Causes

• Splenectomy / hyposplenism
• Acute / chronic infection /inflammation, including e.g. RA, PMR, GCA, IBD ect
• Post-op / trauma 
• Steroids
• Pregnancy
• Smoking - very common
• CML / other myeloproliferative disorders - rare
• Obesity - isolated leucocytosis without other cause has been reported in obeses individuals

Investigations

• Repeat FBC in 6-12 weeks, especially if there is recent acute infection / inflammation / surgery / trauma
• Blood film
• CRP / ESR
• Smoking history, medication e.g. steroids
• Clinical correlation - any recent infection / inflammatory disorders, surgery ect. 

USC referral if:

A blood film is thought to be suggestive of a primary haematological disorder (e.g. CML, the blood film comments will contain advice on what to do next)

Routine referral to haematology if:

Persistent unexplained (i.e. none of the causes -in 'guidelines on management' section- are present) neutrophilia >20 x 10⁹/L

A&G

Consider A&G if unsure

 

• Harrogate and District