What is the significance of leukocytosis in Chronic Obstructive Pulmonary Disease (COPD)?

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Last updated: February 14, 2025View editorial policy

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From the Research

Significance of Leukocytosis in COPD

Leukocytosis, or an elevated white blood cell (WBC) count, is a significant indicator of the severity and progression of Chronic Obstructive Pulmonary Disease (COPD). The following points highlight the importance of leukocytosis in COPD:

  • Leukocytosis is associated with the severity of COPD, independent of other inflammatory conditions, such as metabolic syndrome 1.
  • A higher WBC count is negatively associated with lung function, including forced vital capacity (FVC) and forced expiratory volume in one second (FEV1), in COPD patients 1.
  • The WBC count is also independently associated with the quality of life measure, as assessed by the EQ5D-index score, in COPD patients 1.
  • A high baseline WBC count, particularly neutrophil count, is associated with a higher incidence of long-term acute exacerbation of COPD (AECOPD) 2.
  • The neutrophil-to-lymphocyte ratio (NLR) is a marker of subclinical inflammation and is significantly higher in stable COPD patients compared to healthy individuals, and in patients with AECOPD compared to those with stable disease 3.

Predictive Value of Leukocytosis in COPD

Leukocytosis has predictive value for the development of AECOPD and can be used as a biomarker to assess disease severity and progression. Key findings include:

  • A higher WBC count, neutrophil count, and NLR are associated with an increased risk of AECOPD 2, 3.
  • The NLR is a useful tool in discriminating between COPD patients with stable disease, those with AECOPD, and healthy individuals 3.
  • Leukocytosis, in combination with other inflammatory markers such as C-reactive protein (CRP) and heparin-binding protein (HBP), has diagnostic and predictive value for AECOPD 4.

Association with Glucocorticosteroid Treatment

Glucocorticosteroid treatment can affect WBC count in COPD patients, making it essential to consider this factor when interpreting leukocytosis results. Notably:

  • Systemic glucocorticosteroids can cause leukocytosis, and distinguishing the effect of glucocorticosteroids on leukocyte level from infection-induced leukocytosis is crucial 5.
  • The eosinophil absolute count can be used as a marker of compliance and efficacy of steroid treatment in COPD patients 5.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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