Q: My boyfriend has had a very promiscuous life before we met. He went to the doctor today and had a test done and was told he has elevated WBCs. He is not telling me everything, but he says he is very worried. He is a heavy drinker and has high cholesterol, but no other health problems. He also told me that his doctor called and has re-scheduled his follow up with more results for tomorrow. What do you think is wrong?

A:Leukocytosis is an increase in the total number of white blood cells (WBCs) from any cause and is classified according to the type of white cells that is contributing to it - an increase in neutrophil count (neutrophilia), lymphocyte count (lymphocytosis), monocyte count (monocytosis), eosinophil count (eosinophilia) and basophil count (basophilia). A combination of any of the above may be involved. Leukocytosis is body's reaction to a variety of infectious, inflammatory, and physiologic processes (e.g. severe stress) and is mediated by several chemical compounds, which are released or produced excessively in response to stimuli. Monocytosis is a monocyte count greater than 1000 per microlitre. It is very difficult to give any advice in this case without knowing the detailed history or physical examination. The causes of monocytosis are: certain bacterial infections, such as tuberculosis, syphilis, subacute bacterial endocarditis and brucellosis; many protozoal and rickettsial infections, such as malaria, Rocky Mountain spotted fever, and trypanosomiasis; lymphomas, leukaemia, myelodysplasias, lipid storage diseases, etc.; recovery from acute infection; malignancies, including carcinoma of ovary, stomach and breast; collagen vascular disease, such as lupus erythematosus and rheumatoid arthritis; sarcoidosis, ulcerative colitis, Crohn's disease, and chronic high-dose steroid therapy.