From the FDA Drug Label
Hematologic Eosinophilia (6%), thrombocytosis (5.1%) and leukopenia (2.1%). Less frequently reported (<1%) were anemia, hemolytic anemia, neutropenia, lymphopenia, thrombocytopenia and prolongation of the prothrombin time. Investigations Blood creatinine increased (0. 6%). Other rarely observed adverse reactions (<0. 1%) include abdominal pain, agranulocytosis, allergic pneumonitis, anaphylaxis, basophilia, biliary lithiasis, bronchospasm, colitis, dyspepsia, epistaxis, flatulence, gallbladder sludge, glycosuria, hematuria, jaundice, leukocytosis, lymphocytosis, monocytosis, nephrolithiasis, palpitations, a decrease in the prothrombin time, renal precipitations, seizures, and serum sickness
The cause of elevated neutrophil count is not directly stated in the drug label, but leukocytosis which is an increase in white blood cell count is reported as a rare adverse reaction. 1
From the Research
Elevated neutrophil counts, known as neutrophilia, are commonly caused by bacterial infections, inflammation, physical or emotional stress, certain medications, and some cancers. The most recent and highest quality study 2 suggests that neutrophils play a crucial role in chronic inflammatory diseases, such as atherosclerosis, diabetes mellitus, and autoimmune disorders. Key causes of elevated neutrophil counts include:
- Bacterial infections, which trigger the body's immune response to produce more neutrophils to fight pathogens
- Inflammation from conditions like rheumatoid arthritis or inflammatory bowel disease
- Physical or emotional stress
- Certain medications, particularly corticosteroids like prednisone
- Some cancers, especially leukemia and myeloproliferative disorders
- Smoking, which can chronically elevate neutrophil levels
- Tissue damage from burns, heart attacks, or surgery, which prompts neutrophil production as part of the healing process
- Genetic disorders like Down syndrome, which may feature neutrophilia
- Normal physiological responses like pregnancy or intense exercise, which can temporarily increase neutrophil counts Neutrophils typically make up 55-70% of circulating white blood cells and are the first responders in the immune system, rapidly migrating to sites of infection or injury to eliminate threats through phagocytosis and other mechanisms. When neutrophil counts exceed 7,500 cells per microliter of blood, further investigation is usually warranted to determine the underlying cause, as suggested by the study 2. It is essential to note that the role of neutrophils in chronic inflammation is complex and can be either beneficial or detrimental, causing tissue damage and enhancing the immune response, as highlighted in the study 2. Therefore, it is crucial to investigate the underlying cause of elevated neutrophil counts to provide appropriate treatment and management, considering the potential risks and benefits of therapeutic interventions targeting neutrophils, as discussed in the study 3.