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Q: Please tell me the ins and outs about leukocytosis. What is it -- cancer?

-- M.B. Orlando, Fla.

A: Many medical terms sound a lot worse than they are. This is usually the case for leukocytosis. It simply means an elevation of the number of white blood cells above normal.

The normal number of white blood cells found in one cubic centimeter (1 cc) of blood ranges from 3,500 to 10,000, so a reading above 10,000 would be considered leukocytosis.

There are five main types of white blood cells, and two of those, neutrophils and lymphocytes, make up about 65 percent and 30 percent of the total, respectively. As a result, leukocytosis usually means an increase in neutrophils but may sometimes mean an increase in lymphocytes.

Neutrophils are usually increased as the result of a bacterial infection, but sometimes they may be increased during early stages of viral infections, with generalized inflammation, chronic stress, tumors, drugs and diabetic ketoacidosis. Very rarely, an increased level is also a sign of a type of cancer -- leukemia.

An increase in lymphocytes, on the other hand, is more often the result of a viral infection, thyroid problem, drug reaction, allergic reaction or autoimmune disease. An increase in lymphocytes is also more likely to indicate leukemia.

Technicians look at the cells under a microscope. If leukocytosis is an indicator of cancer, the white cells will look abnormal.

A white blood cell test is normally done as part of routine medical check-ups and is often done as a standard test when someone is sick. There are two reasons for tests to be elevated even when a person is not sick. The first is lab error and the second is that a person "normally" is different from the standard norm. Because of the possibility of lab error, if a lab result will have a major impact on your medical care, repeat the test.

It's important to understand the meaning of "normal" when referring to test results. The standard meaning in medicine for normal is that 95 percent of people without disease will have test results within the "normal" range. By definition, 5 percent of people will have an abnormal test when they are not sick.

The best way to know if your normal number is higher than the standard "normal" is to keep a record of your test results over the years, especially for screening tests done when you are not sick.

Keeping records helps you know when your test is not really high and also when a "normal" test is really an indication of disease.

Say, for example, that your white blood cell tests always run from 3,500 to 5,000. Then one day when you're sick you have a test reading of 10,000. That would be within the normal range, but, because it's much higher than normal for you, it may indicate a medical problem.

As always, keeping a medical diary can be helpful for you and your doctor in diagnosing and treating medical problems.

Update on child abuse: More than 50,000 children suffer from shaken baby syndrome every year in North America. Shaking a young child can cause irreversible brain damage, blindness, cerebral palsy, hearing loss, spinal cord injury, seizures, learning disabilities, mental retardation and even death.

As many as half of all parents and caretakers don't know how harmful a small amount of shaking can be. And the younger the child is, the less it takes to do a lot of damage, because a baby's brain and blood vessels are not yet developed and their neck muscles are weak.

So if you are concerned about your own or other children please contact the National Exchange Club Foundation for the Prevention of Child Abuse at (800) 760-3413 or visit its Web site at

Dr. Allen Douma welcomes questions from readers. Although he cannot respond to each one individually, he will answer those of general interest in his column. Write to Dr. Douma in care of Tribune Media Services, 435 N. Michigan Ave., Suite 1400, Chicago, Ill. 60611. His e-mail address is

This column is for informational and educational purposes only. It is not intended to provide medical advice or take the place of consultation with a doctor or other health-care provider.

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