Neutrophil norms in women, men and children by age, causes of deviations, additional examinations and treatment

White blood cells or leukocytes themselves are heterogeneous. This is the general name for five structures. The goal of all of them is the same: the fight against infectious and other abnormal agents that invade the human body. Accordingly, they form the basis of the immune system.

Neutrophils are one of the subtypes of leukocytes. They are most numerous in relation to other similar cells and make up up to 70% of the total mass of such cells. They perform important functions but are heterogeneous in nature.

In a sense, these structures are universal, capable of fighting most types of pathogens and foreign objects. Deviations from the norm always indicate the development of pathological processes, not counting a small number of subjective reasons, for example, taking certain medications.

The appropriateness of treatment is determined by the specific clinical situation. Neutrophils in a blood test reflect immune function, therefore any deviation is potentially dangerous, which is what doctors proceed from when considering the need for therapy.

Functions of neutrophils

These cells solve a large group of specific tasks facing the human body’s defenses:

Release of bactericidal substances

The structures of cytological units contain specialized compounds that have the ability to kill pathogenic flora. When a target is detected, the neutrophil releases a substance that dissolves the cell membranes of the pathogen.

Thus, the genetic material is not encapsulated and the bacterium dies. This is one of the main mechanisms of neutrophil activity.

Antigen binding

The cells in question on the membranes have special receptors for specific immunoglobulins of class G; they are the most common in the body and are highly active in the fight against infectious agents of all types.

Due to the ability to bind such substances, neutrophils can quickly transport them to the site of injury to enhance the immune response. Thus, the destruction of pathogens is achieved much faster.

Direct absorption of microorganisms

Formed cells are capable of phagocytosis. They are large and aggressive enough to destroy bacteria by “eating” them. On average, a neutrophil can eliminate up to 20-30 foreign structures using different methods. Which indicates its high efficiency.

Inhibition and inactivation of viral agents

White blood cells have the ability to reduce the rate of replication of foreign pathogens and reduce the productivity of their existence. In favorable cases, complete suppression of the structures is achieved, due to which the inflammatory processes disappear.

The functions of neutrophils ultimately come down to one thing - the destruction of bacteria, viruses, fungi, and other objects in various ways. Therefore, an increase in the Neut indicator in a blood test indicates an immune response, be it a reaction to an infectious lesion or allergic processes. Next, you need to understand it in detail, in essence.

What are neutrophils?

Neutrophils, or neutrophilic leukocytes, are the most numerous subtype of white blood cells.
Being present in the blood, neutrophils perform one of the most important functions of protecting the body from the effects of pathogenic bacteria, viruses and other harmful agents. Neutrophils detect a pathogenic microorganism, destroy it, and then die themselves.

The level of neutrophils in the blood is determined by a detailed clinical analysis, which contains information about all types of neutrophils.

Kinds

Neutrophils, despite the same name, are also heterogeneous. There are several types of these. Depending on the functional purpose (narrow specialization) or the degree of readiness for work.

In total, four types can be defined:

• Myelocyte. Relatively speaking, it cannot be called a type of white blood cell. This is an extremely immature cell. In essence, it has not even differentiated yet. This is a rough “preparation” of the organism for future transformation into other structures. Not necessarily neutrophils.

Transformation into anything is possible: from a platelet to an eosinophil. Normally, such structures should not exist in the bloodstream at all. They concentrate in the bone marrow and are finally formed there, only then they enter the body and begin to do their job.

• Young or immature neutrophils. Intermediate form. It is also stored in the place of its own synthesis, providing a conditional reserve. In case more immune cells need to be released. Similar varieties are also absent from the bloodstream. Because they are not yet capable of working.

On the other hand, as a result of random phenomena, a small number of them may be released. This is not critical, but the quantity should be within the error level. About 0.1-1%, with a possible downward deviation. All obvious changes indicate the development of one or another pathological process in the body.

• Band neutrophils. Make up a minimum of the total mass. Not more than 5% of the quantity. They got their name due to the peculiarities of their shape, which is clearly visible during microscopic analysis. These cells have approximately the same functions, but are more highly specialized. They get involved out of necessity when the majority cannot cope.
• Neutrophils are segmented. The most numerous subtype of white blood cells. According to various estimates, it accounts for up to 70% of the number of structures. Solve the problems described above constantly and fully. The work of neutrophils of this type is especially noticeable during the development of an infectious-inflammatory process in the body.

There are thus only two functionally active species. Both of them are approximately equivalent in features, role and potential for combating pathogenic agents, microorganisms, viruses, fungi.

How do they work?

As noted earlier, neutrophils have all the functional abilities of phagocytes:

• Chemotaxis (positive - having left the blood vessel, neutrophils take a course “towards the enemy”, “decisively moving to the site of introduction of the foreign object; negative - the movement is directed in the opposite direction);
• Adhesion (the ability to adhere to a foreign agent);
• The ability to independently capture bacterial cells without the need for specific receptors;
• The ability to act as killers (kill captured microbes);
• Digest foreign cells (“having eaten,” the neutrophil noticeably increases in size).

Video: neutrophil fights bacteria

The granularity of neutrophils gives them the opportunity (as well as other granulocytes) to accumulate a large number of various proteolytic enzymes and bactericidal factors (lysozyme, cationic proteins, collagenase, myeloperoxidase, lactoferrin, etc.), which destroy the walls of the bacterial cell and “deal with” it. However, such activity can also affect the cells of the body in which the neutrophil lives, that is, its own cellular structures, it damages them. This suggests that neutrophils, infiltrating the inflammatory focus, simultaneously with the destruction of foreign factors, also damage the tissues of their own body with their enzymes.

Standard tables

Neutrophils are designated in a blood test as Neut, and the number of cells is calculated as a percentage. But in laboratory and clinical practice, the absolute content of neutrophils is also used, this is an indicator that is calculated in the number of units per liter of blood.

Which method will be used depends on the specific institution and research methods.

Among women

The indicators vary quite widely. On average, the norm of neutrophils in the blood of women is 50-59%, which is slightly higher than that of men. This is due to the peculiarities of the immune system and other factors.

The data in the table is approximate; slight individual fluctuations downward (but not upward) are possible. It is also necessary to take into account the patient’s condition at the time of the study.

Peak hormonal events affect the concentration of neutrophils. Whether it’s active puberty (especially with delayed formation), the menstrual cycle, pregnancy.

In men

In men, normal corpuscle values ​​are not much lower (49-57%), in general, we are talking about a discrepancy of several percent. Depending on the case. This is a general rule.

In adults, the normal range of neutrophils ranges from 30 to 59% on average. The spread is large. A lower limit is also possible and is not considered an anomaly.

The tables present average numbers that do not fully reflect the clinical features and reality of the situation. Therefore, the decoding and interpretation should be done by a doctor.

In children

In this case, it is necessary to calculate not only by year, but also by day, month, depending on the age of the child.

The sharp increase in the first days is due to the active formation of immunity and the appearance in an aggressive external environment. Then there is a gradual adaptation, everything returns to normal after the first few years of life.

Absolute measures give approximately the same results in proportion.

Natural causes of increase

An increase in the concentration of neutrophils (a shift in the leukocyte formula to the right) is not always of an abnormal origin. Although this is true for most possible clinical situations.

If we talk about natural factors, they will be like this:

• Pregnancy. Gestation creates a large load on the mother’s body, and all immune processes intensify. Which ultimately causes an increase in levels in a laboratory study. This is not dangerous, because the answer is false. However, just in case, you need to check other indicators. Sluggish manifestation of pathology is possible.
• Delivery.
• The menstrual cycle and the period right before it. The body considers the natural monthly processes of egg maturation and release as intense stress. The result is a false immune reaction. This does not pose any danger; you need to wait until the end of the period and everything will return to normal on its own.
• Exercise stress. The more intense it is, the more significant the deviations in neutrophil levels will be. Levels return to adequate levels without medical assistance or external influence in general.
• Consuming large amounts of food. In general, food causes a temporary increase in the concentration of formed cells. The relationship is directly proportional. Everything returns to normal after a few hours.

Stress affects performance in the same way. This also applies to any emotional manifestations.

Pathological factors for increasing neutrophil concentration

The norm of neutrophils in the blood changes mainly for abnormal reasons. If we talk about specific conditions:

• Inflammatory processes. There are two types. Infectious. The most numerous group. It is typical for them to enter the body of foreign structures. Ultimately, increasing the levels of neutrophils and more is an adequate and correct response of the body to an external attack.

The situation is somewhat more complicated with the second subtype of the pathological process. When an autoimmune response develops. Inflammatory phenomena of this kind are characterized by the absence of a pathogen as such. The body attacks itself, its own cells.

This is the result of a malfunction of the immune system. Neutrophils do not perform a useful function, but the increase is obvious.

• Endocrine disorders. Mainly those that provoke severe metabolic disorders. The leader of this group is considered to be diabetes mellitus. This can also include pathologies of the thyroid gland and adrenal glands. Various types.
• Malignant tumors. Regardless of location and type. Neutrophil counts especially increase if bone marrow function is disrupted. Metastases or primary neoplasia, this no longer plays a role in the context of determining the causes.
• In addition to the actual diseases, they call the iatrogenic factor. That is, all kinds of traumatic surgical interventions. The change in levels persists throughout the entire rehabilitation period. Only then does it fade away.

Please note:
There are a few exceptions to the rules. If neutrophils in an obvious pathological process are within the normal range, this is not natural. We are talking about the weakness of the immune system; it is necessary to treat the underlying disease as quickly as possible.

What do the changes in the analysis indicate?

Increased neutrophil levels

An increase in the level of neutrophils in the blood is called neutrophilosis (neutrophilia).

Deviation from the norm of segmented neutrophils may indicate the following pathologies and conditions:

• Infectious diseases
• Pathologies of the lower extremities,
• Oncological diseases,
• Functional disorders of the urinary system,
• Rheumatoid inflammatory diseases,
• Increased blood sugar levels.

Exceeding the norm of band neutrophils occurs in acute infectious and inflammatory diseases, which provoke an acceleration of the penetration of immature neutrophils into the bloodstream.

The number of young neutrophils above normal is a consequence of:

• Pneumonia,
• Otitis,
• Pyelonephritis,
• Surgical intervention and postoperative period,
• Dermatitis,
• Holistic skin disorder
• Various types of injuries,
• Thermal, chemical burns,
• Gout,
• Rheumatoid diseases,
• Neoplasms of malignant/benign nature,
• Anemia (polysegmentation of neutrophils is observed),
• Autoimmune diseases,
• Extensive blood loss,
• Fluctuations in ambient temperature,
• Hormonal changes during pregnancy.

An upward deviation from the norm in band neutrophils can be caused by excessive physical or emotional stress.

There is also an increase in immature neutrophils while taking certain medications, such as:

• Heparin
• Corticosteroids
• Adrenalin
• Medicines containing the foxglove plant.

Band neutrophilia is observed during intoxication with lead, mercury or insecticides.

Uniform growth of band and segmented neutrophils is observed with:

• Localized purulent inflammations (appendicitis, infections of the ENT organs, tonsillitis, acute pyelonephritis, adnexitis, etc.),
• Generalized purulent inflammation (peritonitis, scarlet fever, sepsis, etc.),
• Necrotic processes (stroke, gangrene, heart attacks, etc.),
• Disintegration of a malignant neoplasm,
• Ingestion of bacterial toxins into the body without infection by the bacteria themselves (example: entry into the body of botulism toxin formed when the bacteria themselves die).

Neutrophilia is classified according to severity:

Neutrophilia is asymptomatic and is most often detected by chance.

Decreased neutrophil levels

A condition in which the number of neutrophils in the blood is below normal is called neutropenia or agranulocytosis.

The classification of neutropenia is based on the course of the pathology:

• Chronic neutropenia , which lasts longer than 1 month,
• Acute neutropenia , developing from several hours to several days.

Neutrophil shift to the left is divided into degrees:

• Light – 1-1.5 x 109/l,
• Average – 0.5-1 x 109/l
• Heavy less than 0.5 x 109/l

The following types of agranulocytosis are distinguished:

• Primary , which is observed more often in patients 6-18 months of age. Primary agranulocytosis is characterized by an asymptomatic course. Sometimes pain in different localizations, cough syndrome, inflammation of gingival tissues, gingival bleeding,
• Secondary , the development of which is observed mainly in adults and is associated with previous autoimmune pathologies.
• Absolute , developing with whooping cough, sepsis, typhoid fever, acute leukemia, infectious mononucleosis,
• Relative , occurs in patients under the age of 12 years and is explained by the physiological characteristics of a person,
• Cyclic , characterized by the periodic development of fungal or bacterial diseases, the manifestation of symptoms with a frequency of 4-5 days every 3 weeks. Clinical manifestations of this form of the disease are migraine, fever, inflammation of small joints, inflammation of the throat, tonsils,
• Autoimmune , in which a decrease in neutrophil levels is associated with taking certain medications. Often found in patients with dermatomyositis, rheumatoid arthritis, and autoimmune diseases. A decrease in the level of cells in the blood is provoked by taking analgin, anti-tuberculosis drugs, immunosuppressants, and cytostatics. Also, this type of pathology occurs during long-term antibacterial therapy with drugs of the penicillin group.
• Febrile , which is the most dangerous form of the disease. The condition is characterized by a sudden and rapid decrease in the level of neutrophils to critical values ​​(below 0.5 x 109/l). The development of pathology is observed during or immediately after chemotherapy, which is used to treat cancer. Febrile agranulocytosis indicates the presence of an infection in the body, the timely detection of which is often impossible. A small number of neutrophils in the blood leads to the rapid spread of infection in the body, which often leads to death. Characterized by a sharp increase in temperature to subfebrile levels, tachycardia, hypotension, weakness, profuse sweating,

The reasons for the decrease in neutrophil levels are:

• Infections,
• Inflammatory processes
• Taking certain medications
• Chemotherapy,
• Pathological processes in the spinal cord,
• Lack of vitamins
• Heredity.

Symptoms of neutropenia include:

• Febrile and subfebrile temperature,
• Ulceration of mucous membranes,
• Pneumonia,
• Sinusitis, sinusitis, rhinitis,
• Meningitis.

Changes in the leukocyte formula, including shifts in the level of neutrophils, almost always indicate the presence of a particular disease in the body. If any neutrophil changes are detected in a blood test, it is important to undergo a detailed examination and the necessary treatment.

If neutrophils in the blood deviate from the norm, it is very important to identify the cause of the disturbance as soon as possible.

The following can be used for diagnosis:

• X-ray examination of the chest,
• X-ray examination of ENT organs,
• Analysis of urine,
• Blood test for HIV,
• Bone marrow puncture.

Treatment of neutropenia and neutrophilosis is aimed primarily at treating the underlying disease that caused a violation of the level of neutrophils in the blood.

Reasons for the downgrade

There are also many factors that shift the leukocyte formula to the left.

• HIV. Huge problem. The pathological process provokes depression of the entire immune system. In this case, even against the background of a real threat, damage to the body, there will be no growth indicators at all. On the contrary, they will be lowered. Maintenance therapy is required.
• Aplastic anemia. Accompanied by a violation of the synthesis of all possible formed blood cells. Leukocytes of different types are no exception here. Without specific treatment, potentially fatal complications are likely. Action needs to be taken faster.

• Severe infectious processes. In this case, the need for shaped cells for active combat is growing. The body may not have time to produce new ones, hence the temporary decline.
• General weakness of all systems. Neutrophils are lower than normal if a person has suffered a serious illness in the recent past or does not receive enough nutrients.
• History of alcoholism. The same goes for those who drink heavily. The concentration of neutrophils is less than adequate values, since their synthesis is suppressed by ethanol breakdown products. The general exhaustion of the body of such people also affects.
• Hepatitis. Inflammatory process of the liver. It has an infectious, particularly viral origin.
• Sepsis. Generalized damage to the body.
• Radiation sickness.
• Intoxication. In case of poisoning with certain poisons. A group of drugs also has a similar effect. The possibility of such a side effect is reflected in the annotations for specific pharmaceutical products.

All causes and mechanisms of development of neutropenia (low concentration of neutrophils) are described in this article.

Reasons for the increase in some cells and the decrease in others

It is necessary to take into account other factors of growth or decrease in indicators. This applies to natural, natural phenomena caused by physiology. There are many shaped cells designed to fight external attacks. In this case, several situations are possible.

• Neutrophils are increased and lymphocytes are decreased. The first phase of eliminating foreign structures is underway. The central immunity is not yet active enough, and there is no need for it. If effective, changes in laboratory parameters will not be so significant.
• If neutrophils are low and lymphocytes are high, this indicates the second phase of the defense response. When central cells begin to work more actively, and local-level structures temporarily reduce the intensity of activity.

Without going into complex biological mechanisms, it is worth mentioning the general rule: when neutrophils increase, lymphocytes decrease and vice versa. This is normal and natural. There is no simultaneous increase or decrease observed.

What additional examinations are needed?

Usually, a general blood test is sufficient to establish the fact of an increase in the level of neutrophils. It shows a fairly comprehensive picture of the shaped cells.

But this is not enough. To understand the situation and help the patient, the main task is to identify the root cause of the disorder. This is somewhat more complicated and requires additional research.

• Oral survey. Allows you to evaluate a person’s complaints about the condition. The symptomatic complex gives an idea of ​​the primary source of infection or other factors of deviation.
• Anamnesis collection.
• X-ray of the chest organs.
• Visual assessment of the condition of the oropharynx and ENT organs in general.
• Study of biochemistry indicators.
• Ultrasound of the abdominal cavity.

Other activities are scheduled as needed. It all depends on the hypotheses expressed by the specialist. There may be several specialized doctors here, because we are not talking about a specific diagnosis, but about a laboratory finding. First of all, it makes sense to contact a therapist (pediatrician).

When is research necessary?

If the doctor has even the slightest suspicion of the presence of an inflammatory process, he will refer the patient for a blood test. Most often, indications for diagnostics are:

Segmented neutrophils

• angina;
• pneumonia;
• sepsis;
• appendicitis;
• peritonitis;
• thermal injuries;
• gangrene;
• rheumatic attacks;
• heart attack;
• tuberculosis;
• bleeding;
• chemical poisoning.

Treatment

Correction is determined by the specific cause of the pathological process. The goal is not to raise neutrophils in the blood using artificial methods; it is necessary to eliminate the source of the problem. Drug therapy is practiced.

In case of infectious genesis of the disorder, the following means are used:

• Antibiotics. Different types.
• Stimulators of leukocyte synthesis. Leukogen and others. Carefully.
• Local antiseptic drugs.

If we are talking about autoimmune reactions:

• Suppressors. To suppress the activity of protective forces.
• Glucocorticoids. Prednisolone and similar.
• Others may be used. According to the needs and prescription of the treating specialist.

The number of neutrophils in the blood also shows the effectiveness of therapy, therefore it is possible to study the quality of the correction carried out according to this criterion.

Otherwise, the techniques depend on the clinical situation. Diabetes mellitus requires glucose control, malignant tumors require surgical treatment, etc.

Decoding the results

The neutrophil norm determined for a particular woman can only be compared with the result of a blood test by a professional doctor. The ability to decipher a study is mandatory for making a diagnosis and prescribing medical treatment.

A standard blood test involves examining 5 types of leukocytes. If cells of an atypical structure are detected, the analyzer signals the need to double-check the result “manually” under a microscope. The list of results most often includes only the “leukocytes” criterion.

In case of diagnosed abnormalities, the study results form will also include a detailed leukocyte formula. The obtained indicator values ​​should be compared not only with their reference analogues, but also with the generally accepted norm for women of a particular age and the characteristics of their current physical condition.