Q: In a case of elevated WBCs i.e. leukocytes, what is polymorphonuclear leukocytosis? How serious is this? Is it life threatening? The affected person also had anisocytosis? Kindly advise. The patient has a history of high WBCs at least since 1997 and TLC has been ranging from 12,000 to 20,000.

A:The white blood cells (leukocytes) comprise two types of cells (a) Granulocytes (b) Mononuclear cells The granulocytes are neutrophils, eosinophils and basophils while mononuclear cells are lymphocytes and monocytes. Neutrophils are also referred to as polymorphonuclear leukocytes. An increase in their numbers is known as leukocytosis. They are increased in stress (allergic reactions, burns, poisoning, surgery, trauma, etc), infections (usually bacterial), inflammatory states (including different arthrites and collagen vascular diseases), leukaemia, malignancy and due to drugs. If there is persistent neutrophilia, the cause needs to be investigated and this would require a thorough physical examination and appropriate tests. The possibility of chronic myeloid leukaemia needs to be ruled out. Anisocytosis refers to the variability in the size of the red cells and is seen in different anaemias, especially due to iron deficiency.