From the Guidelines
Elevated monocytes, or monocytosis, is a condition that requires immediate medical attention to identify and address the underlying cause, as it can be indicative of a serious infection, inflammation, or other health issues. This condition occurs when the count of monocytes in the blood exceeds 800 cells per microliter. According to the study published in the European Heart Journal 1, monocyte count is highest in malignant effusions and hypothyroidisms, which suggests that elevated monocytes can be a marker for certain types of cancer or thyroid disorders.
The approach to treating elevated monocytes will depend on identifying and addressing the root cause. Common causes include chronic infections (like tuberculosis or endocarditis), inflammatory conditions (such as inflammatory bowel disease or rheumatoid arthritis), certain cancers (particularly leukemia and lymphoma), and autoimmune disorders. No specific medication directly treats monocytosis itself; instead, treatment targets the underlying condition. For example, antibiotics would be prescribed for bacterial infections, while anti-inflammatory medications might be used for inflammatory disorders.
Recent studies, such as the one published in Hypertension 2, have also highlighted the importance of the immune system in cardiovascular disease, and how conditions like COVID-19 can affect monocyte and macrophage hyperactivation, leading to increased circulating levels of pro-inflammatory cytokines. This suggests that elevated monocytes can also be a marker for cardiovascular risk.
Regular follow-up blood tests may be necessary to monitor monocyte levels and evaluate treatment effectiveness. Lifestyle factors like chronic stress, smoking, and poor diet can sometimes contribute to inflammatory responses that elevate monocytes, so addressing these factors may help support overall immune health. It is essential to consult with a healthcare provider for proper evaluation and treatment, as elevated monocytes can be a sign of a serious underlying condition.
Some key points to consider when evaluating elevated monocytes include:
- Identifying the underlying cause of the elevated monocytes
- Monitoring monocyte levels and evaluating treatment effectiveness
- Addressing lifestyle factors that may contribute to inflammatory responses
- Considering the potential link between elevated monocytes and cardiovascular risk
- Consulting with a healthcare provider for proper evaluation and treatment.
From the Research
Elevated Monocytes
- Elevated monocytes, also known as monocytosis, can be caused by a wide variety of neoplastic and non-neoplastic conditions 3
- The evaluation of monocytosis involves the integration of laboratory data, morphology, clinical findings, and the judicious use of ancillary studies 3
- Monocytosis is a frequently encountered clinical condition that needs appropriate investigation due to a broad range of differential diagnoses 4
- A stepwise diagnostic approach is recommended for a patient presenting with monocytosis, including basic studies and flow cytometry studies to distinguish the different etiologies 4
Diagnostic Approach
- The diagnostic approach to monocytosis should include a review of the patient's clinical history, physical exam, and laboratory results 3, 4
- Flow cytometry studies can be used to distinguish chronic myelomonocytic leukemia from other reactive or neoplastic causes of monocytosis 4
- Monocyte repartitioning can be used to distinguish chronic myelomonocytic leukemia from other causes of monocytosis 4
Laboratory Tests
- Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are widely used laboratory markers of systemic inflammation, but they lack sensitivity and specificity 5, 6
- CRP is a better indicator of inflammation than ESR, and it is more sensitive and responds more quickly to changes in the clinical situation 6
- ESR has value in detecting low-grade bone infection, and in monitoring some patients with systemic lupus erythematosus 6