From the Guidelines
Slightly elevated monocytes typically indicate an immune response to infection, inflammation, or other health conditions, and while not an immediate cause for concern, warrant follow-up with a healthcare provider to determine the underlying cause. The presence of elevated monocytes, also known as monocytosis, can be associated with various conditions, including bacterial infections, viral illnesses, inflammatory conditions, and certain cancers 1. According to the 2017 Infectious Diseases Society of America clinical practice guidelines, a monocyte predominance may suggest the presence of an intracellular pathogen such as Salmonella 1.
Key Considerations
- Common causes of elevated monocytes include:
- Bacterial infections
- Viral illnesses like mononucleosis
- Inflammatory conditions such as rheumatoid arthritis
- Certain cancers
- Recovery from acute stress or illness
- No specific medication is needed solely for elevated monocytes; instead, treatment focuses on addressing the underlying cause
- Additional tests like a complete blood count with differential, inflammatory markers, or specific tests for suspected conditions may be recommended by a healthcare provider 1
Next Steps
While waiting for a follow-up appointment, it is essential to maintain healthy habits, including:
- Adequate rest
- Proper hydration
- A balanced diet to support the immune system
- Monitoring for any changes in symptoms or condition, and reporting them to a healthcare provider promptly.
From the Research
Slightly Elevated Monocytes
- Slightly elevated monocytes can be caused by a wide variety of neoplastic and non-neoplastic conditions 2.
- The evaluation of monocytosis involves the integration of laboratory data, morphology, clinical findings, and the judicious use of ancillary studies 2.
- A stepwise diagnostic approach is recommended for a patient presenting with monocytosis, including basic studies and flow cytometry to distinguish between different etiologies 3.
Diagnostic Approach
- The discovery of a monocytosis requires confirmation by reading under a microscope by an experienced biologist to overcome usual cytological traps 4.
- In most cases, the secondary origin of monocytosis is easily found by context and/or the presence of a biological inflammatory syndrome 4.
- In some cases, the diagnosis may be directed towards an eosinophilic pathology or an acute leukemia, while in other cases, chronic myelomonocytic leukemia (CMML), myeloproliferative neoplasm (MPN), or myelodysplastic syndrome (MDS) with monocytosis may be highlighted 4.
Laboratory Tests
- The complete blood count (CBC) is one of the most frequently ordered laboratory tests in medicine and includes the white blood cell count and differential 5.
- Mean cell volume of neutrophils (MNV) and monocytes (MMV) can be used as diagnostic markers for predicting systemic clinical infection (sepsis) 6.
- Interleukin-6 (IL-6) and C-reactive protein (CRP) can also be used as predictors for sepsis, with IL-6 being the best predictor at a designated cut-off point 6.