From the Research
Pure neutrophilia in clinically stable patients can result from several causes, including physiological stress responses, medications, chronic inflammatory conditions, occult infections, smoking, myeloproliferative disorders, and certain solid tumors. The most common causes of pure neutrophilia include physiological stress responses, such as after strenuous exercise or during pregnancy, which trigger cortisol release that mobilizes neutrophils from the bone marrow 1. Medications are also frequent culprits, particularly corticosteroids (like prednisone), lithium, and colony-stimulating factors (G-CSF) 2. Some key points to consider when evaluating pure neutrophilia in clinically stable patients include:
- Chronic inflammatory conditions like rheumatoid arthritis, inflammatory bowel disease, or vasculitis can cause persistent neutrophilia even when patients appear clinically stable 1
- Occult infections, especially those that are chronic or partially treated, may present with neutrophilia before other symptoms become apparent 3
- Smoking is a well-established cause of neutrophilia, with the effect being dose-dependent and potentially persisting for weeks after cessation 1
- Myeloproliferative disorders such as chronic myeloid leukemia or polycythemia vera can present initially with isolated neutrophilia 4
- Certain solid tumors, particularly lung, breast, and gastrointestinal cancers, can stimulate neutrophil production through cytokine release 1 When evaluating neutrophilia in stable patients, it's essential to consider these possibilities and obtain a thorough medication history, smoking status, and screen for underlying inflammatory conditions or occult malignancy if the neutrophilia persists without explanation 1.