From the Guidelines
Your white blood cell (WBC) count of 12.8 shows a mild elevation above the normal range, but it does not meet the criteria for an elevated WBC count (>14,000 cells/mm3) that would warrant a careful assessment for bacterial infection, as suggested by the Infectious Diseases Society of America guidelines 1.
Key Findings
- The WBC count has been gradually increasing over time from 10 to 11.6 to the current level of 12.8.
- The neutrophil count is elevated at 8.3, which may suggest a possible inflammatory process.
- The lymphocyte and monocyte counts are within normal ranges, and there are no immature granulocytes.
Recommendations
- Discuss these results with your healthcare provider at your next appointment, but urgent evaluation is not necessary unless you develop symptoms like fever, fatigue, unexplained weight loss, or night sweats.
- Regular monitoring of your blood counts over the next few months would be reasonable to ensure stability or identify any concerning trends.
- Various factors can cause mild WBC elevation, including stress, medications, smoking, or underlying chronic conditions, which should be considered in the evaluation of your condition, as noted in studies on leukocytosis and infection in older adults 1.
From the Research
White Blood Cell Count
- The patient's white blood cell (WBC) count is 12.8, which is higher than the previous year's count of 10 and last week's count of 11.6 2, 3.
- The differential count shows neutrophils at 8.3, lymphocytes at 3.2, monocytes at 1.1, and no immature granulocytes.
- The patient does not have any fevers, which could indicate an infectious cause for the elevated WBC count 2, 3.
Potential Causes
- Leukocytosis, or an elevated WBC count, can have various causes, including malignant and nonmalignant conditions, infections, and inflammatory processes 2, 3.
- Stressors such as surgery, exercise, trauma, and emotional stress can also cause an acute leukocytosis 2, 3.
- Certain medications, asplenia, smoking, obesity, and chronic inflammatory conditions can also contribute to an elevated WBC count 2, 3.
Prognostic Value
- An elevated WBC count has been associated with an increased risk of cardiovascular events in patients with hypertension 4 and vasospastic angina 5.
- In patients with acute lymphoblastic leukemia, a markedly elevated WBC count (≥200 × 10^9/L) is associated with a poorer outcome 6.
- However, the patient's WBC count is not significantly elevated to the extent seen in these studies, and the clinical context is different.
Next Steps
- A repeat complete blood count with peripheral smear may provide helpful information, such as types and maturity of white blood cells, uniformity of white blood cells, and toxic granulations 2.
- The patient's symptoms and medical history should be thoroughly evaluated to identify any potential causes for the elevated WBC count 2, 3.